Aortic root reinforcement in aortic valve endocarditis with annular abscess: The Calamari procedure

Petrov, Asen; Diab, Abdel-Hannan; Taghizadeh-Waghefi, Ali; Wilbring, Manuel; Alexiou, Konstantin; Matschke, Klaus; Tugtekin, Sems Malte; Kappert, Utz

doi:10.1111/jocs.16517

Cited by 2 publications

(3 citation statements)

References 6 publications

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“…After an extensive literature search, we have only found one case report from 1 month prior to our report documenting an approach to seating an aortic conduit within the left ventricular outflow tract. Petrov et al report good outcomes with this technique, which they have named the Calamari procedure due to the resemblance of the Dacron ring to a Calamari ring [13]. Our case illustrates the feasibility and safety of this technique when necessary for advanced disease.…”

Section: Discussionmentioning

confidence: 52%

Feasibility of Low-Seated Composite Aortic Conduit for Surgical Treatment of Prosthetic Valve Endocarditis: A Case Report

Bharadwaj¹,

Chiu²,

Mehta³

2022

JSCR

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Background: A 49-year-old male presented with a delayed diagnosis of infective endocarditis leading to extensive intracardiac destruction. Such cases present technical challenges to operative debridement as crucial anchoring points for replacement conduits are compromised. Case Presentation: Our patient presented at age 49 with nausea, lethargy, and diarrhea 2 weeks after recent travel. His prior history included bioprosthetic valve replacement for a bicuspid aortic valve. The patient was first given a trial of antimicrobials for a suspected UTI. Subsequently, he was admitted briefly to an outside hospital for a “cardiac work-up,” which returned negative. The patient sought care for the third time, during which he developed unstable supraventricular tachycardia, prompting echocardiography 16 days following the onset of symptoms. Echocardiography demonstrated a 6 cm abscess cavity invading the interventricular septum with a fistula into the left ventricular outflow tract, multiple ventricular septal defects (VSD), and suspected fistulae into the right ventricular outflow tract. The patient was treated with valve explant and extensive debridement. A valved-conduit for the aorta could not be sewn to the aortic annulus in the usual fashion due to destruction and debridement of the annulus, so a neo-annulus was created using the anterior leaflet of the mitral valve and the left ventricular outflow tract of the heart below the level of the VSDs. A mechanical-valved conduit was implanted onto the neo-annulus. A pacemaker was subsequently implanted. Conclusion: In patients with extensive intracardiac destruction with the compromise of the aortic annulus due to infective endocarditis, a low-seated, mechanical-valved conduit implanted directly to the aorto-mitral curtain and left ventricular outflow tract should be considered a novel, durable reconstructive option that allows complete debridement of infected tissues.

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Section: Discussionmentioning

confidence: 52%

Feasibility of Low-Seated Composite Aortic Conduit for Surgical Treatment of Prosthetic Valve Endocarditis: A Case Report

Bharadwaj¹,

Chiu²,

Mehta³

2022

JSCR

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“…The study by Asen Petrov et al, 3 paves the way for a new, safe, simple, and useful Calamari technique for the treatment of aortic valve endocarditis complicated by aortic root abscess (ARA). After the excision of the infected aortic valve and the debridement of the aortic annulus, a ring with a length of approximately 5 mm and a diameter 3 mm bigger than the measured aortic annulus is excised from a Dacron aortic prosthesis (Calamari ring).…”

Section: Commentarymentioning

confidence: 99%

“…The study by Asen Petrov et al, 3 This technique was initially described in a series of five patients.…”

Section: Commentarymentioning

confidence: 99%

The best is the enemy of the good, a simple technique to treat a complex disease: Calamari procedure

Ramirez

Nasso²,

Bari

2022

Journal of Cardiac Surgery

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Infective endocarditis is a life-threatening condition and despite advances in antibiotic therapy, about one-third of patients require surgical treatment. The choice of the most appropriate surgical treatment is crucial. The study by Asen Petrov et al.paves the way for a new, safe, simple, and useful Calamari technique for the treatment of aortic valve endocarditis complicated by aortic root abscess (ARA). This technique was initially described in a series of five patients. The most interesting part

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Aortic root reinforcement in aortic valve endocarditis with annular abscess: The Calamari procedure

Cited by 2 publications

References 6 publications

Feasibility of Low-Seated Composite Aortic Conduit for Surgical Treatment of Prosthetic Valve Endocarditis: A Case Report

Feasibility of Low-Seated Composite Aortic Conduit for Surgical Treatment of Prosthetic Valve Endocarditis: A Case Report

The best is the enemy of the good, a simple technique to treat a complex disease: Calamari procedure

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