Unusual Cause of Heart Failure in a Patient with Marfan Syndrome: A Late Complication of Bioprosthetic Valved Graft Replacement.

Publisher: published in the Cardiovascular Surgical Research Laboratories, Texas Heart Institute Country of Publication: United States NLM ID: 8214622 Publication Model: eCollection Cited Medium: Internet ISSN: 1526-6702 (Electronic) Linking ISSN: 07302347 NLM ISO Abbreviation: Tex Heart Inst J Subsets: MEDLINE

Original Publication: Houston, TX : published in the Cardiovascular Surgical Research Laboratories, Texas Heart Institute, c1982-

Bioprosthesis* ; Blood Vessel Prosthesis* ; Blood Vessel Prosthesis Implantation*/adverse effects ; Blood Vessel Prosthesis Implantation*/instrumentation ; Heart Valve Prosthesis Implantation*/adverse effects ; Heart Valve Prosthesis Implantation*/instrumentation; Aortic Aneurysm/*surgery ; Aortic Valve/*surgery ; Graft Occlusion, Vascular/*etiology ; Heart Failure/*etiology ; Marfan Syndrome/*complications; Aged ; Aortic Aneurysm/diagnostic imaging ; Aortic Aneurysm/etiology ; Aortic Valve/diagnostic imaging ; Aortic Valve/physiopathology ; Device Removal ; Echocardiography, Doppler ; Graft Occlusion, Vascular/diagnostic imaging ; Graft Occlusion, Vascular/physiopathology ; Graft Occlusion, Vascular/surgery ; Heart Failure/diagnostic imaging ; Heart Failure/physiopathology ; Heart Valve Prosthesis ; Humans ; Male ; Marfan Syndrome/diagnosis ; Prosthesis Design ; Recovery of Function ; Treatment Outcome ; Ventricular Function, Left

A high-velocity gradient across the left ventricular outflow tract is most often caused by aortic valve stenosis. We describe the unusual case of a high-velocity gradient caused by a kinked ascending aortic graft in a 69-year-old man who had Marfan syndrome. The patient had a history of ascending aortic aneurysm and had previously undergone replacement of the aortic root and ascending aorta with use of a bioprosthetic valved graft. The kinking was caused by dilation of the native aortic arch. The patient underwent successful hemi-arch replacement and repair of the kinked graft. Late complications and reoperation after proximal aortic surgery in patients with Marfan syndrome are rare, and a high-velocity left ventricular outflow tract gradient caused by the kinking of the aorta is unusual.
(© 2020 by the Texas Heart® Institute, Houston.)

J Med Ultrason (2001). 2015 Apr;42(2):291-2. (PMID: 26576588)
JBR-BTR. 2013 Jan-Feb;96(1):27-9. (PMID: 23610878)
J Am Coll Cardiol. 2009 Jul 14;54(3):191-200. (PMID: 19589431)
Eur J Echocardiogr. 2010 Sep;11(8):645-58. (PMID: 20823280)
Ann Thorac Surg. 1986 Jan;41(1):70-4. (PMID: 3942435)
Echocardiography. 2016 Nov;33(11):1753-1761. (PMID: 27613242)
J Thorac Imaging. 2012 Jul;27(4):W88-90. (PMID: 21516042)
Eur J Echocardiogr. 2008 Jan;9(1):160-1. (PMID: 17714998)
Radiology. 1997 Jun;203(3):727-32. (PMID: 9169695)
Eur J Cardiothorac Surg. 2004 May;25(5):671-5. (PMID: 15082265)

Keywords: Aortic diseases/pathology; Marfan syndrome/complications; echocardiography, Doppler/methods; heart failure/etiology; reoperation; treatment outcome; ventricular outflow obstruction/diagnostic imaging/etiology/physiopathology

Date Created: 20200310 Date Completed: 20201214 Latest Revision: 20201214

20231215

PMC7046353

10.14503/THIJ-18-6618

32148452