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    Composite graft endocarditis - Repair with a mechanical prosthesis
    (Texas Heart Inst, 2004) Apaydin, AZ; Posacioglu, H; Islamoglu, F; Degirmenciler, K; Durmaz, I
    We report the case of a 64-year-old man who developed a mediastinal pseudoaneurysm due to severe endocarditis, 2 years after aortic root replacement with a prosthetic composite graft containing a mechanical valve. After a short period of stabilization and antibiotic therapy, the patient underwent surgery. The coronary buttons and the sewing ring of the composite graft were found to be detached from the graft and the annulus, respectively. Re-replacement with a prosthetic composite graft (Dacron graft with a mechanical valve) by the Cabrol procedure was performed. Although the homograft is considered by many surgeons to be the best graft for aortic root replacement, the synthetic composite graft can also be used to treat composite graft endocarditis successfully. The technical aspects of homograft versus synthetic aortic root replacement in patients with endocarditis are discussed briefly.
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    Detachment of the mitral anterior leaflet as a complication of aortic valve replacement
    (Texas Heart Inst, 2006) Islamoglu, F; Apaydin, AZ; Degirmenciler, K; Gurgun, C; Durmaz, I
    Mitral regurgitation after aortic valve replacement is generally reported as a complication of a Manouguians procedure for annulus enlargement. However even if no annular enlargement procedure is performed, this complication may be encountered after isolated aortic valve replacement because of either extensive decalcification of the aortic annulus or progressive tension on the anterior leaflet of the mitral valve, caused by aortic valve sutures placed adjacent to firm or heavily calcified valve tissue. Routine transthoracic echocardiography may be inadequate for diagnosis of this condition; transesophageal echocardiography should be used both for preoperative diagnosis and for intraoperative management. We report the case of a patient who had severe mitral regurgitation that occurred after aortic valve replacement with a mechanical valve.