1/15. Acute heart failure due to local dehiscence of aortic wall at aortic valvular commissure. Spontaneous dehiscence of the aortic wall at the aortic commissure is not recognized as one of the usual pathological causes of aortic regurgitation. We describe the case of a 56-year-old man with hypertension, who experienced acutely progressive congestive heart failure due to massive aortic regurgitation. Local layer dehiscence around the commissure was noted with partial detachment of the commissure resulting in the loss of commissural support with secondary rupture of a non-coronary cusp, which led to massive aortic regurgitation. ( info) |
2/15. Valvuloplasty for aortic valve regurgitation resulting from cusp prolapse. Three adults, 2 with tricuspid aortic valve and 1 with bicuspid valve, underwent valvuloplasty for aortic valve regurgitation resulting from cusp prolapse. Surgical procedures consisted of combined cusp plication by triangular cusp resection and subcommissural annuloplasty. Doppler echocardiography revealed trivial aortic valve regurgitation intraoperatively and less than I/IV at discharge in all cases. After mean follow-up of 15 months, 2 tricuspid aortic valve patients remain I/IV regurgitation and II/IV in the bicuspid patient. Although long-term results remain unclear, our results show that this procedure is feasible and beneficial in patients with aortic valve regurgitation due to cusp prolapse. ( info) |
3/15. Aortic laceration due to prolapse of the bicuspid aortic valve: case report. Reports of aortic regurgitation due to rupture of the aortic valve commissures are rare. Prompt surgical intervention is necessary, as the condition results in rapid, progressive heart failure and subsequent death. We report the case of a 78-year-old man who presented with aortic laceration and cardiac tamponade that was probably induced by prolapse of the bicuspid aortic valve. We speculate that prompt initial surgery may have prevented aortic laceration and cardiac tamponade in this patient. Thus, in order to optimize clinical outcome, clinicians must consider early, precautionary surgical management in patients who have sudden cardiac failure due to aortic regurgitation associated with prolapse of the bicuspid aortic valve. ( info) |
4/15. Aortic root replacement with anomalous origin of the coronary arteries. Coronary arteries with anomalous origin from the aorta can be at risk during aortic valve procedures. We report a case of origin of the circumflex and left coronary artery from the proximal right coronary artery in a patient with a bicuspid aortic valve and aortic root aneurysm. attention to the anatomic relationship of the anomalous arteries to the aorta allowed safe aortic root replacement. ( info) |
5/15. Anomalous right coronary artery from the main pulmonary artery in a patient with double-chambered right ventricle. We describe a rare case of double-chambered right ventricle (DCRV) in a 32-year-old female presenting to the echocardiography lab for evaluation of congenital heart disease. We identified a unique constellation of findings, including the DCRV, a perimembranous ventricular septal defect, aortic valve prolapse, patent foramen ovale, and an anomalous right coronary artery coming off the main pulmonary artery. To the best of our knowledge, this is the first reported case describing the association of an anomalous right coronary artery coming off the main pulmonary artery in a patient with DCRV. ( info) |
6/15. Juvenile spondyloarthritis and severe cardiac involvement in a female patient. Heart involvement is a recognized complication in 10-20% of all adults with spondyloarthritis. Until now only 8 cases of cardiac involvement in juvenile spondyloarthritis (JS) have been reported, all male patients. We describe the first female patient with JS, in whom progressive cardiac involvement developed, and summarize the pediatric JS cases with cardiac involvement. ( info) |
7/15. A cluster of cases of aspergillus endocarditis after cardiac surgery. aspergillus endocarditis is an ominous condition whose prevalence is increasing in the hospital population. Despite the life-threatening nature of the disease, detection of the source, establishment of the diagnosis, and treatment remain highly challenging. A cluster of three cases of aspergillus endocarditis recently encountered at the Montreal Heart Institute are presented. ( info) |
8/15. Aortic regurgitation due to aortic root intimal tear as a result of blunt chest trauma. We report a 31-year-old male patient who sustained blunt trauma to the chest, abdomen and left knee resulting in a liver laceration, left patella fracture and aortic regurgitation. Hepatorrhaphy, open reduction of the fractured patella and resuspension of the prolapsed aortic valve secondary to the aortic root intimal tear were performed subsequently. Prompt diagnosis and aggressive intervention of such injuries can lead to successful repair of potentially fatal cardiac trauma. ( info) |
| A 22 year old man with Marfan's syndrome died suddenly following acute aortic valve prolapse. Although aortic root involvement in Marfan's syndrome is common, we have found no previous description of this particular complication in the literature. ( info) |
10/15. Abbreviated aortic insufficiency in aortic dissection caused by prolapse of the intimal flap. Aortic insufficiency was identified in a patient with acute ascending aortic dissection. The aortic insufficiency was limited to the first half of diastole by prolapse of the intimal flap against the regurgitant orifice. This unusual pathophysiology was well demonstrated by two-dimensional and color flow Doppler echocardiography. ( info) |