HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Richard Hopkins Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hopkins, R. Articles by Atalay, M. Search for Related Content PubMed Articles by Hopkins, R. Articles by Atalay, M. Related Collections Valve disease

J Thorac Cardiovasc Surg 2008;135:214-216
© 2008 The American Association for Thoracic Surgery

Brief Communication

Stable partial dehiscence of aortic homograft inserted freehand by using the subcoronary intra-aortic root noncoronary sinus Ross scallop inclusion technique

^a Division of Cardiothoracic Surgery and the Cardiac Surgical Research Institute, Children’s Mercy Hospital, Kansas City, Mo
^b Drexel University College of Medicine, Philadelphia, Pa
^c College of Osteopathic Medicine and Surgery, Des Moines University, Des Moines, Iowa
^d Department of Anesthesiology, Rhode Island Hospital and Brown Medical School, Providence, RI
^e Department of Diagnostic Imaging, Brown Medical School, Providence, RI.

Received for publication March 6, 2007; revisions received April 3, 2007; accepted for publication April 11, 2007.

^_* Address for reprints: Richard Hopkins, MD, Adult/Adolescent Congenital Cardiac Surgery, Cardiac Surgical Research Institute, Children’s Mercy Hospital, 4 West Tower-Cardiac Surgery, 2401 Gillham Rd, Kansas City, MO 64108. (Email: rahopkins@cmh.edu).

The first 20% of the full text of this article appears below.

Technical error with homograft aortic valve replacements, particularly with the subcoronary technique, although rare (<2%), is the most common cause of early to midterm failures.¹ In general, these technical difficulties result in progressive aortic insufficiency and failure of the homograft. In this case, the patient has had a partial dehiscence for 15 years of the upper portion of the noncoronary cusp flange, which was inserted in the subcoronary position within the aortic root by using the modified scallop cylinder-subcoronary inclusion technique (minimal scallop of noncoronary sinus per the 1987 Ross method).^2,3

Clinical Summary

A 60-year-old patient presented 15 years after aortic valve replacement with a cryopreserved human aortic valve homograft. The patient was doing extremely well and was very active, including running and working out with weights. Echocardiographic analysis, cardiac magnetic resonance imaging, and computerized cardiac tomographic analysis all demonstrated excellent aortic valve geometry and ventricular function but also a "fluttering" of the top of the noncoronary cusp of the homograft aortic valve within the aortic root that was timed to the cardiac cycle (Figure 1). Review of serial postoperative echocardiograms over the past 15 years indicated that this . . . [Full Text of this Article]

This article has been cited by other articles:

				P. H. Schoof Stentless valve dehiscence J. Thorac. Cardiovasc. Surg., July 1, 2008; 136(1): 231 - 231. [Full Text] [PDF]