Aortic valve perforation

Fowler, Noble O.; Hamburger, Morton; Bove, Kevin E.

doi:10.1016/0002-9343(67)90053-8

Cited by 36 publications

(14 citation statements)

References 16 publications

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“…16 AP was reportedly a common finding in patients who underwent aortic valve replacement for severe aortic insufficiency and acute heart failure complicating LNVIE. 1,5 In 1 report of 10 patients who underwent aortic valve replacement for acute aortic insufficiency, all patients had evidence of AP. 19 Much of the aforementioned data are decades old.…”

Section: Perforation and Mortalitymentioning

confidence: 99%

“…In the pre-echocardiography era, AP was thought to correlate clinically with acute worsening of heart function and hemodynamic parameters preceding death. 1 This led to the perception that AP contributed to higher mortality. This assumption was not verified premortem until recently, in 1 small echocardiographic study in which AP was identified as an independent predictor for surgery and death.…”

Section: Introductionmentioning

confidence: 99%

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Valvular Perforation in Left‐sided Native Valve Infective Endocarditis

Bachour¹,

Zmily²,

Kizilbash³

et al. 2009

Clinical Cardiology

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Background: Left-sided native valve infective endocarditis (LNVIE) can result in mitral (MP) and aortic (AP) valve perforation, the prognostic significance of which remains poorly defined. Hypothesis: Valvular perforation is associated with worse outcomes. Methods: Retrospective review of patients with LNVIE during 1998-2005 was performed to examine characteristics and outcome predictors of LNVIE complicated by valve perforation. Patients were stratified as: group A: MP or AP detected by transesophageal echocardiography (TEE) or surgery; group B: no TEE evidence of MP or AP. Results: A total of 123 patients were included (group A = 47, group B = 76). In group A, 35 patients (74.5%) had MP alone, 11 (23.4%) had AP alone, and 1 patient had both. Severe valvular insufficiency was encountered more in group A (85.1% versus 59.2%, p = 0.003), so was hemodialysis (40.4% versus 17.1%, p = 0.004) and indications for valvular surgery (93.6% versus 77.6%, p = 0.02). Group A had a higher rate of in-hospital death (31.9% versus 15.8%, p = 0.04). Among patients who had an indication for valvular surgery, the in-hospital mortality rate for those who underwent valvular surgery was 16.7% in group A, and 7.9% in group B (p = 0.4), compared to those who did not undergo surgery (71.4% versus 33.3%, p = 0.04). Amongst survivors, hospital stay was on average 9.2 d longer in group A (38.9 versus 29.7 d, p = 0.05). Univariate analysis revealed association between lower survival and valvular perforation (odds ratio [OR]: 0.4, 95% confidence interval [CI]: 0.17-0.95), that was lost after adjusting for hemodialysis. Conclusions: Valve perforation complicating LNVIE is associated with hemodialysis, severe valvular insufficiency, and significant morbidity and mortality. Compared to conservative management, early surgical intervention is associated with improved survival.

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Section: Perforation and Mortalitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Valvular Perforation in Left‐sided Native Valve Infective Endocarditis

Bachour¹,

Zmily²,

Kizilbash³

et al. 2009

Clinical Cardiology

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“…Infective endocarditis is a common cause for aortic leaflet perforation (Fowler et al, 1967), however; occurrence of aortic valve perforation after cardiac operation may raise suspicion for iatrogenic cause.…”

Section: Introductionmentioning

confidence: 99%

Aortic Valve Leaflet Perforation after Mitral Valve Repair

Aboelnasr

Rohn

2013

Prague Med. Rep.

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R e c e i ve d D e c e m b e r 9 , 2 0 1 2 ; A c c e p t e d A u g u s t 1 4 , 2 0 1 3 . Key words: Aortic regurgitation -Aortic valve perforation -Mitral valve repairAbstract: A 32-year-old patient with symptomatic severe aortic regurge, 6 weeks after mitral valve repair, was admitted for aortic valve surgery. No preoperative clinical data consistent with infective endocarditis could be detected. Preoperative transthoracic echocardiography showed aortic leaflet perforation affecting non coronary cusp. During operation, leaflet perforation was detected and closed completely with autologous pericardial patch. No vegetations or abscess could be seen during operation. Iatrogenic aetiology of leaflet perforation after mitral repair was suspected in this case. Recognition of this complication will help in avoiding it during mitral valve surgery and expecting it as a possible complication during intraoperative transesophageal echocardiography.

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“…Aortic regurgitation caused by a leaflet perforation is most frequently seen in association with infective endocarditis that involves the aortic valve [1,2]. A suture-related injury to an aortic valve can produce leaflet perforation with aortic regurgitation after such cardiac surgery as mitral valve replacement [8], repair of a ventricular septal defect (VSD) [6,8] and repair of an atrial septal defect (ASD) [7,8].…”

Section: Introductionmentioning

confidence: 99%

A case of iatrogenic aortic valve leaflet perforation after closure of a ventricular septal defect

Woo

Koh

Chang

et al. 2010

Int J Cardiovasc Imaging

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Aortic regurgitation caused by leaflet perforation is most frequently seen in association with infective endocarditis that involves the aortic valve. There have been occasional reports of iatrogenic aortic regurgitation caused by aortic valve injury after cardiac surgery with the use of the transaortic approach or invasive cardiac procedures. Suture-related aortic valve injury can develop during periaortic cardiac surgery, but this has been very rarely reported. Inadvertent injury to an aortic valve leaflet caused by a stitching needle or surgical forceps can produce leaflet perforation with aortic regurgitation. This report describes a case of aortic regurgitation that was caused by iatrogenic aortic valve leaflet perforation, and this occurred in a 22-year-old woman who underwent repair of a ventricular septal defect (VSD) 15 years previously. Transthoracic echocardiography (TTE) showed a defect located at the aortic annulus close to the infundibular septum on a two-dimensional echocardiographic study and we observed an eccentric jet flow into the left ventricle in early diastole on the continuous wave and color flow Doppler studies. A small perforation in the body of the right aortic cusp and mild to moderate aortic regurgitation were confirmed by the use of transesophageal echocardiography (TEE) and ascending aortography.

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Aortic valve perforation

Cited by 36 publications

References 16 publications

Valvular Perforation in Left‐sided Native Valve Infective Endocarditis

Valvular Perforation in Left‐sided Native Valve Infective Endocarditis

Aortic Valve Leaflet Perforation after Mitral Valve Repair

A case of iatrogenic aortic valve leaflet perforation after closure of a ventricular septal defect

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