ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Paul R. Vogt
Marko I. Turina
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Zünd, G.
Right arrow Articles by Turina, M. I.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Zünd, G.
Right arrow Articles by Turina, M. I.

Ann Thorac Surg 1999;67:1805
© 1999 The Society of Thoracic Surgeons

Images in Cardiothoracic Surgery

Green aortic valve: alcaptonuria (ochronosis) with severe aortic stenosis

Gregor Zünd, MDa, Andreas C. Schmid, MDa, Paul R. Vogt, MDa, Jürg Grünenfelder, MDa, Marko I. Turina, MDa

a Clinic for Cardiovascular Surgery, University Hospital, Zurich, Switzerland

Address reprint requests to Dr. Zund, Clinic for Cardiovascular Surgery, University Hospital Zurich, Ramistrasse 100, D-Lab 32, CH-8091 Zurich Switzerland
e-mail: gregor.zundchi.usz.ch

A 67-year-old woman with known alcaptonuria presented herself with a 4-week history of dyspnhea (NYHA II) and edema of the lower limbx. Upon presentation, electrocardiography showed negative T-waves in the chest leads; she had a slight elevation of myoglobin and troponin I. Transthoracic echocardiography showed a severe aortic stenosis with a systolic pressure gradient of 69 mm Hg and mild mitral regurgitation with thickening of both mitral valve leaflets. Cardiac catheterization revealed secondary pulmonary hypertension, diffuse narrowing of the left anterior descending artery, obliteration of the circumflex branch, and marked stenosis of the right coronary artery.

The patient underwent surgery using cardiopulmonary bypass. Oblique aortotomy revealed a tricuspid aortic valve with thickened, dark green aortic valves. The aortic wall and the left ventricular outflow tract had a similar appearance, as shown in Figure 1.



View larger version (147K):
[in this window]
[in a new window]
  		Fig 1.
 
Aortic valve replacement, using a 21-mm "Top-Hat" valve (Carbomedics, Austin, TX) and coronary artery bypass grafting using both internal thoracic arteries was performed. The patient’s postoperative course was complicated by her preexisting pulmonary hypertension, requiring prolonged mechanical ventilation. However, the patient was discharged from the intensive care unit 2 weeks after surgery and remains well.




This article has been cited by other articles:


Home page
 Clin Med ResHome page
A. A. Fisher and M. W. Davis
Alkaptonuric Ochronosis with Aortic Valve and Joint Replacements and Femoral Fracture: A Case Report and Literature Review
Clin. Med. Res., November 1, 2004; 2(4): 209 - 215.
[Abstract] [Full Text] [PDF]

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Paul R. Vogt
Marko I. Turina
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Zünd, G.
Right arrow Articles by Turina, M. I.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Zünd, G.
Right arrow Articles by Turina, M. I.

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS