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. 2019 Aug 5;5(1):125.
doi: 10.1186/s40792-019-0682-x.

Florida sleeve technique for a right sinus of Valsalva aneurysm: a case report

Kosuke Saku  1 , Satoru Tobinaga  2 , Atsunobu Oryoji  2 , Tomofumi Fukuda  2 , Yasuyuki Zaima  2 , Hiroyuki Saisho  2 , Takahiro Shojima  2 , Kazuyoshi Takagi  2 , Tohru Takaseya  2 , Hiroyuki Tanaka  2
Affiliations

Florida sleeve technique for a right sinus of Valsalva aneurysm: a case report

Kosuke Saku et al. Surg Case Rep. .

Abstract

Background: Florida sleeve technique was reported by Hess et al. as a new technique of valve sparing aortic root replacement without the requirement of entire aortic root wall resection and coronary artery reconstruction. We present a rare case of an unruptured aneurysm of the right sinus of Valsalva that was successfully treated with resection of the aneurysm and the Florida sleeve technique.

Case presentation: A 72-year-old man was admitted for the treatment of an unruptured aneurysm of the right sinus of Valsalva. Computed tomography showed an aneurysm of the right sinus of Valsalva measuring > 40 mm and protruding into the right ventricular outflow tract. The aneurysm dilated up to 5 mm per year, and the left sinus of Valsalva and non-coronary sinus of Valsalva also showed dilation, and he underwent resection of only the right sinus of Valsalva aneurysm and valve sparing aortic root replacement with the Florida sleeve technique.

Conclusions: We performed valve-sparing aortic root replacement with the Florida sleeve technique. It could reduce surgical risks and prevent a dilatation of the residual sinus of Valsalva through coverage with a graft for a long term.

Keywords: Aortic root replacement; Florida sleeve; Sinus of Valsalva aneurysm.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Preoperative computed tomography. a, b An unruptured right SVA protrudes into the right ventricular outflow tract. c RSV, 47 mm; LSV, 38 mm; NCSV, 37 mm. Ao: aorta; SVA, sinus of Valsalva aneurysm: RV, right ventricle; RSV: right sinus of Valsalva; LSV: left sinus of Valsalva; NCSV: non-coronary sinus of Valsalva
Fig. 2
Fig. 2
a The right SVA is excised, leaving about 5 mm of the aortic wall. b, c Operative schema. The aortic root is covered with a 28-mm Valsalva graft having a left side “coronary keyhole.” Seven subannular sutures are placed at the commissures and midpoint of the left and non-coronary cusps, and two are placed at the right coronary cusp. The residual right sinus of Valsalva wall is sutured with 5–0 monofilament polypropylene pledged with Teflon felt to reinforce the fragile aortic wall. SVA: sinus of Valsalva aneurysm; RSV: right sinus of Valsalva; LSV: left sinus of Valsalva; NCSV: non-coronary sinus of Valsalva; RCA: right coronary artery; LCA: left coronary artery
Fig. 3
Fig. 3
Computed tomography taken 2 years after the operation. There was no distortion or stenosis associated with the covered graft at the left main coronary artery trunk. RCA: right coronary artery; LCA: left coronary artery
See this image and copyright information in PMC

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