A Case of Three Directional Cuff Leakage from the Stent Posts of an Inspilis RESILIA Aortic Valve during Surgical Aortic Replacement
- VernacularTitle:インスピリスRESILIA大動脈弁を用いた大動脈弁置換術中に3カ所の交連部直下から逆流を生じ，Paravalvular leakageとの鑑別を要した1例
- Author:
Masaaki IKEHARA
1
;
Masaru KANBE
2
;
Kozo MORITA
1
;
Hiroshi NIINAMI
1
Author Information
- Keywords: inspiris RESILIA aortic valve; paravalvular leakage; transvalvular leakage; echocardiogram; aortic valve replacement
- From:Japanese Journal of Cardiovascular Surgery 2024;53(2):62-65
- CountryJapan
- Language:Japanese
- Abstract: We present the case of a 72-year-old male with Inspiris RESILIA aortic valve (Inspiris) transvalvular leakage during surgical aortic valve replacement (AVR). The patient initially underwent AVR for aortic regurgitation with a bicuspid aortic valve at the age of 64. By the age of 72, the valve had deteriorated and it was assessed that redoing the AVR was necessary. The Inspiris was inserted in the supra-annular position using the non-everting mattress suture technique with a COR-KNOT. During weaning off from cardiopulmonary bypass, transesophageal echocardiography (TEE) captured unfamiliar turbulent flows from the three stent posts. Further TEE revealed that these flows originated from the base of the stent posts, which gradually decreased and disappeared by the end of the surgery after administration of protamine. The patient has been discharged uneventfully. Paravalvular leakage has not been observed during the postoperative course and we could not find TVL in TEE 2 months postoperatively. While considering the detailed mechanism, it is possible that there is no need for re-exploration concerning three directional TVL in the Inspiris.
