Sutureless bioprostheses have been used to facilitate complex multivalvular procedures, and difficult aortic root surgery. We report images of a patient in which a sutureless bioprosthesis was inserted into a heavily calcified aortic root without guiding sutures.A 39‐year‐old male presented with exertional dyspnea 16 years following a full root replacement with a cryopreserved aortic homograft for endocarditis. A transthoracic echocardiogram (TTE) revealed severe aortic regurgitation with a mean aortic gradient of 23 mmHg. A chest computed tomography (CT) scan showed extensive circumferential calcification of the homograft and aortic root (Figure ). Following a resternotomy, the institution of cardiopulmonary bypass and cardioplegic arrest, a transverse aortotomy revealed that the left coronary cusp was detached. The remaining leaflets were excised. The root was extensively calcified such that it was impossible to place any sutures through the annulus. A size “S” Perceval aortic sutureless valve (LivaNova, London, UK) was positioned in the annular plane without the use of guiding sutures. The unique “valve‐on‐a stick” design of this valve, with its small diameter in the collapsed form, allowed for easier passage through the sinotubular junction, and to assess its position visually before deployment in the annular plane. The patient tolerated the procedure well, and
Journal of Cardiac Surgery – Wiley
Published: Jan 1, 2018
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