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Ann Thorac Surg 2007;83:2210-2213
© 2007 The Society of Thoracic Surgeons

Case Reports

Late Disruption of a Freestyle Stentless Bioprosthesis Used for Repair of Sinus of Valsalva Aneurysm of Noncoronary Cusp

Yoshiyuki Takami, MDa,*, Hiroshi Masumoto, MDb, Biliie Fyfe-Kirschner, MDc

a Department of Cardiovascular Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
b Division of Cardiovascular Surgery, Kasugai Municipal Hospital, Kasugai, Japan
c Department of Pathology, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey

Accepted for publication January 8, 2007.

* Address correspondence to Dr Takami, Department of Cardiovascular Surgery, Nagoya Daini Red Cross Hospital, 2-9 Myouken-cho, Showa-ku, Nagoya, 466-8650, Japan (Email: takami{at}nagoya2.jrc.or.jp).

We present a case of disruption of the porcine aortic wall of the 27-mm Freestyle stentless bioprosthesis 5 years after the subcoronary implantation to exclude the sinus of Valsalva aneurysm of the noncoronary cusp. At the urgent reoperation, the inflow suture line was found to be intact, and therefore a new stented valve was sutured with the inflow Dacron cuff after removal of ruptured valve. The subcoronary implantation technique creates a cavity between the prosthetic and native aortic walls filled with hematoma. The outflow suture line dehiscence caused blood flow into the cavity, porcine aortic wall rupture, and leaflet destruction.




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