Successful Stentless Aortic Valve Replacement Navigated by VR Images in a Case of Bicuspid Aortic Stenosis with Valsalva Sinus Asymmetry
- VernacularTitle:Valsalva 洞が不均一な大動脈二尖弁狭窄症に対する SOLO SMART 生体弁置換術において，大動脈基部の三次元的計測が有用であった1例
- Author:
Kenichi KAMIYA
1
;
Yuko GATATE
1
;
Tadamasa MIYAUCHI
1
;
Masaomi FUKUZUMI
1
;
Takeo TEDORIYA
1
Author Information
- Keywords: stentless bioprosthesis; aortic valve replacement; bicuspid aortic valve; sinus of Valsalva; virtual reality
- From:Japanese Journal of Cardiovascular Surgery 2018;47(6):267-271
- CountryJapan
- Language:Japanese
- Abstract: SOLO SMART is a stentless bioprosthesis that comprises a larger effective orifice area and reduced pressure gradient, exhibiting a better hemodynamic profile than a stented bioprostheses. Currently, SOLO SMART finds application in patients with aortic valve diseases. However, patients with bicuspid aortic valve disease may present Valsalva sinus asymmetry. Recently, some studies have considered SOLO bioprosthesis as contraindicated in patients with a bicuspid aortic valve. Here, we report the case of a 79-year-old female with bicuspid aortic stenosis and Valsalva sinus asymmetry. We preoperatively assessed the aortic root of the patient using a novel 3D workstation that creates virtual reality (VR) images from cardiac CT data. After creating three symmetric commissures at the wall of the Valsalva sinus, we evaluated the distance from the coronary orifices. We determined the appropriate suture line of bioprosthesis avoid coronary orifice occlusion. Aortic valve replacement with SOLO SMART was successful, and the postoperative clinical course was uneventful. Hence, preoperative evaluation of the aortic root using VR images could be a precise and useful method for the assessment of the operative indication for SOLO SMART.
