Medtronic Freestyle Aortic Root Bioprosthesis Implantation for the Infective Endocarditis on Aortic Root

Aortik Root İnfektif Endokarditinde Medtronik Freestyle Aortik Root Bioprotez İmplantasyonu

Mehmet Ali ŞAHİN, Adem GÜLER, Zekeriya ARSLAN, Murat TAVLAŞOĞLU, Leyla GÜLER

Özet

İnfektif endokardit ve periannuler abse formasyonu, geniş cerrahi debridman veaortik root replasmanı gerektiren ciddi bir kalp cerrahisi problemidir. Bu makaledebaşarılı bioprotez implantasyonu yaptığımız iki infektif endokardit vakasını sunacağız. Ekokardiyografik olarak tanı konulan biri prostetik diğeri nativ iki destrüktif aort kapak endokarditli hastada, konjestif kalp yetmezliği, NYHA klas-IV eforkapasitesi mevcuttu. Radikal cerrahi debridman uygulanan iki hastaya MedtronicFreestyle stentless aortik root bioprotez implante edildi. Antibiyotik tedavisi altıhaftaya tamamlandı. Erken ve geç dönem mortalite olmadı. Bir hasta iki gün en- tübe kaldı ve A-V tam blok nedeniyle hastaya kalıcı pacemaker takıldı. On aylıktakiplerinde bioprotez fonksiyonları normaldi ve endokardit bulgusu saptanmadı.Aort kapak ve root infektif endokardit tedavisinde Medtronic Freestyle stentlessaortik root bioprotez, homogreftlerin çok iyi bir alternatifi olabilir.

Abstract

Infective endocarditis and periannular abscess formation are serious problems incardiac valve surgery, requiring extensive surgical debridement and reconstruction of the aortic annulus. We aimed to report two cases which were successfullytreated with bioprosthetic valve implantation for infective endocarditis. Tran- sosephageal echocardiography were performed for the diagnosis of one prosthetic and one native destructive aortic valve endocarditis in association with congestive heart failure (NYHA class-VI) and abscess formation. Medtronic Freestylestentless aortic root bioprosthesis was implanted into the left ventricular outflowtract after surgical radical aortic root debridement for each patient followedwith medical treatment, which was extended to six weeks. Neither early nor latemortality was detected. One patient required prolonged ventilatory support (twodays) and permanent DDD-R pacing. Echocardiography showed no signs of valvedysfunction or recurrent endocarditis for both patients in 10 months follow up. Medtronic Freestyle stentless aortic root bioprosthesis may be a good alternativeway of treatment to aortic valve and root endocarditis instead of homograft.