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Ann Thorac Surg 1980;29:1-7
© 1980 The Society of Thoracic Surgeons

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Articles

Surgical Management of Left Ventricular–Aortic Discontinuity Complicating Bacterial Endocarditis

Department of Surgery, School of Medicine, University of North Carolina, Chapel Hill, NC

Accepted for publication April 20, 1979.

^* Address reprint requests to Dr. Frantz, Clinical Sciences Building 229-H, University of North Carolina, Chapel Hill, NC 27514

Successful hemodynamic repair of left ventricular–aortic discontinuity complicating bacterial endocarditis in 2 patients was achieved using a composite valve–woven Dacron tube graft. The prosthetic valve was sutured without tension into the remaining aortic annulus, ventricular muscle, and base of the aortic leaflet of the mitral valve. Use of the composite graft allows adequate debridement of the abscess, restores ventricular-aortic continuity, excludes the abscess wall from systemic pressure, and does not require saphenous vein coronary bypass. Total exclusion of the aortic root, as described, is a lifesaving alternative repair in the care of desperately ill patients with this condition.

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