Abstract
Young patients with bicuspid aortic valve disease and aortopathy remain a clinical
challenge, with many requiring multiple corrective operations throughout their lifetimes.
Innovative surgical approaches are often required to address complex aortic pathologic
conditions but leave patients at risk for reintervention, lifelong anticoagulation,
and suboptimal hemodynamics. We describe an active 44-year-old female triathlete with
recurrent bicuspid aortic stenosis, a small aortic root, a hypoplastic aortic arch
and complex distal arch, and a descending aortic aneurysm, who underwent a single-stage
reconstruction with a combined Ross procedure, hybrid arch, and frozen elephant trunk
reconstruction.
Résumé
La bicuspidie aortique et l’aortopathie pour lesquelles plusieurs jeunes patients
requièrent de multiples chirurgies correctrices au cours de leur vie demeurent un
défi clinique. Les approches chirurgicales novatrices sont souvent nécessaires pour
traiter les états pathologiques complexes de l’aorte, mais exposent les patients aux
risques de réintervention, d’anticoagulation à vie et d’hémodynamie sous-optimale.
Nous décrivons une triathlonienne active de 44 ans ayant une sténose récurrente de
la valve bicuspide, une petite racine aortique, une hypoplasie de l’arc de l’aorte
et une hypoplasie complexe de l’arc distal, ainsi qu’un anévrisme de l’aorte descendante,
qui a subi une reconstruction en une seule étape combinant l’intervention de Ross,
la reconstruction hybride de l’arc et la reconstruction dite de la « trompe d’éléphant
gelée ».
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References
- Bicuspid aortic valve disease and ascending aortic aneurysms: gaps in knowledge.Cardiol Res Pract. 2012; 2012: 145202
- Under-use of the Ross operation—a lost opportunity.Lancet. 2014; 384: 559-560
- Total aortic arch replacement with the frozen elephant trunk technique: 10-year follow-up single-centre experience.Eur J Cardiothorac Surg. 2013; 44: 949-957
- Total aortic arch replacement with a novel 4-branched frozen elephant trunk prosthesis: single-center results of the first 100 patients.J Thorac Cardiovasc Surg. 2016; 152: 148-159
- What is the role of the Ross procedure in today's armamentarium?.Can J Cardiol. 2013; 29: 1569-1576
Article info
Publication history
Published online: July 14, 2016
Accepted:
July 11,
2016
Received:
June 5,
2016
Footnotes
See page 1576.e14 for disclosure information.
Identification
Copyright
© 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
