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Case Reports
. 2024 Sep 10;8(9):ytae496.
doi: 10.1093/ehjcr/ytae496. eCollection 2024 Sep.

Aortic dissection extending into the interventricular septum following redo aortic valve replacement surgery in a patient with Takayasu's arteritis: a rare case report

Chan-Han Hu  1 , Chun-Hao Chang  2 , Meng-Ta Tsai  2 , Wei-Chuan Tsai  1 , Mu-Shiang Huang  1   3
Affiliations
Case Reports

Aortic dissection extending into the interventricular septum following redo aortic valve replacement surgery in a patient with Takayasu's arteritis: a rare case report

Chan-Han Hu et al. Eur Heart J Case Rep. .

Abstract

Background: Takayasu's arteritis is an infrequent manifestation of vasculitis affecting the aorta and its primary branches with numerous symptoms. This report details a rare case wherein a patient developed interventricular septal dissection following aortic valve replacement.

Case summary: A middle-aged woman diagnosed with Takayasu's arteritis previously underwent aortic valve replacement with a mechanical valve owing to severe aortic regurgitation. Subsequently, she received a redo aortic valve replacement following an episode of prosthetic valve infective endocarditis with paravalvular leak. Heart failure symptoms emerged during follow-up, revealing aortic root dissection extending into the interventricular septum, causing significant prosthetic valve movement. A Trido Bentall operation and interventricular septum repair were performed, and the patient recovered smoothly.

Discussion: Interventricular dissection, although uncommon, may be due to factors such as infection, myocardial infarction, congenital anomalies, trauma, or post-surgical shear stress. Timely diagnosis is imperative to prevent life-threatening complications; surgery remains the primary treatment. The present case report describes a rare presentation that was successfully managed through a Bentall operation and underscores the necessity of prompt intervention in treating this condition.

Keywords: Aortic dissection; Case report; Interventricular septal dissection; Takayasu’s arteritis.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Parasternal long axis view of an echocardiogram performed during outpatient follow-up revealing a mispositioned bioprosthetic valve (the short arrows) and aortic root dissection extending into the interventricular septum (the long arrow). Ao, aorta.
Figure 2
Figure 2
Apical five-chamber view of the echocardiogram depicting a dissected interventricular septum (the long arrow) and a mispositioned prosthetic aortic valve (the short arrows).
Figure 3
Figure 3
Chest computed tomography revealing interventricular dissection measuring 3 × 4 cm2.
Figure 4
Figure 4
Aortic bioprosthetic valve was detached surgically. The surgical view with the cranial part in the left and the caudal part in the right showed left ventricular outflow tract and interventricular septal dissection.
None
See this image and copyright information in PMC

References

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