Anesth Pain Med.  2016 Apr;11(2):186-189. 10.17085/apm.2016.11.2.186.

Intraoperative paravalvular leakage after sutureless aortic valve replacement corrected with secondary balloon dilatation: A case report

• Lee BR
• Jang J
• Lee SY
• Song JW

• KMID: 2358483
• DOI: http://doi.org/10.17085/apm.2016.11.2.186

Abstract

Sutureless aortic valve replacement was performed in a 72-year-old female patient with severe aortic stenosis who had undergone coronary revascularization and pacemaker implantation. After valve excision, decalcification was deliberately incompletely performed at the commissure of the left- and non-coronary cusp to obtain a regular and circular annular margin. After implantation of the stented valve, no paravalvular leakage was noted on water irrigation testing. Upon weaning from cardiopulmonary bypass, a moderate degree of paravalvular leakage was observed by transesophageal echocardiography at the junction of the left- and non-coronary cusp. Instead of removing the valve and performing more complete decalcification to implant a larger valve, secondary balloon dilatation and warm sterile water irrigation were performed to allow further expansion and fixing of the metal alloy stent around the aortic wall to minimize the duration of aortic cross-clamp. No paravalvular leakage was observed thereafter and the patient was discharged without any complications.

Keyword

Paravalvular leakage; Sutureless aortic valve replacement; Transesophageal echocardiography

MeSH Terms

Aged
Alloys
Aortic Valve Stenosis
Aortic Valve*
Cardiopulmonary Bypass
Dilatation*
Echocardiography, Transesophageal
Female
Humans
Stents
Water
Weaning
Alloys
Water

Figure

• 

  Fig. 1 Upon weaning from cardiopulmonary bypass, paravalvular leakage of moderate degree was noted by transesophageal echocardiography examination at the junction of the left-and non-coronary cusp side with a visible gap of approximately 3 mm.

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