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Case Reports
. 2009;36(5):475-6.

Reconstruction of the fibrous trigone

Mehmet H Akay  1 , Magdalena Anna Danch, William E Cohn, O H Frazier
Affiliations
Case Reports

Reconstruction of the fibrous trigone

Mehmet H Akay et al. Tex Heart Inst J. 2009.

Abstract

A 48-year-old man with a history of infective endocarditis and severe aortic regurgitation had undergone prosthetic aortic valve replacement at another institution. Two months later, the patient developed prosthetic valve endocarditis with an aortic root abscess and an aorto-left atrial periprosthetic valvular fistula through the detached posterior annulus of the mitral valve. We repaired the fistula by constructing a fibrous trigone made of bovine pericardium. We also replaced the prosthetic aortic valve with another prosthetic valve, while protecting the native mitral valve.

Keywords: Aortic valve replacement; endocarditis/complications/surgery; fistula/etiology/surgery; heart valve prosthesis/adverse effects; mitral valve repair; prosthesis-related infections; reoperation.

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Figures

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Fig. 1 Drawing shows reconstruction of the fibrous trigone with bovine pericardium (A), which was attached to the mitral annulus (B). The annulus was also reconstructed with bovine pericardium. Multiple interrupted pledgeted mattress sutures were passed through the cut edge of the anterior leaflet and the bovine pericardium that was used to reinforce the annulus (C). These same sutures were then passed through the sewing ring of the aortic prosthesis.
See this image and copyright information in PMC

References

    1. Agnihotri AK, McGiffin DC, Galbraith AJ, O'Brien MF. The prevalence of infective endocarditis after aortic valve replacement. J Thorac Cardiovasc Surg 1995;110(6):1708–24. - PubMed
    1. Calderwood SB, Swinski LA, Waternaux CM, Karchmer AW, Buckley MJ. Risk factors for the development of prosthetic valve endocarditis. Circulation 1985;72(1):31–7. - PubMed
    1. Wang A, Athan E, Pappas PA, Fowler VG Jr, Olaison L, Pare C, et al. Contemporary clinical profile and outcome of prosthetic valve endocarditis. JAMA 2007;297(12):1354–61. - PubMed
    1. Habib G, Tribouilloy C, Thuny F, Giorgi R, Brahim A, Amazouz M, et al. Prosthetic valve endocarditis: who needs surgery? A multicentre study of 104 cases. Heart 2005;91(7): 954–9. - PMC - PubMed
    1. Anguera I, Miro JM, San Roman JA, de Alarcon A, Anguita M, Almirante B, et al. Periannular complications in infective endocarditis involving prosthetic aortic valves. Am J Cardiol 2006;98(9):1261–8. - PubMed

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