Immediate and Late Complications in Aortic Valve Replacement Surgery

A. Costache, Oana-Petronela Oancea, S. Luca, O. Mitu, F. Mitu
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Abstract

Abstract Congenital aortic bicuspid valve can evolve rapidly and at an early age to a severe aortic disease with significant stenosis and regurgitation. Therefore, cardiovascular surgery with mechanical aortic prosthesis implant is the only therapeutic solution. Despite a successful surgical procedure, complications can be numerous, especially post-operatively, as conduction disorders and arrhythmias. Also, given the recent guidelines recommendations to maintain the INR values above 2,5, chronic oral anticoagulation is critical in the long-term prevention of cardioembolic events. Thus, we are presenting the case of a patient diagnosed with a severe aortic disease secondary to a bicuspid aortic valve, who underwent a Bentall surgical procedure, later suffering a wide spectrum of complications, both immediate and late, especially due to long-term subtherapeutic INR values. The particularities of the case reside both in the multitude of complications that occurred in a particular chronological order and in the interfering mechanisms with the anticoagulant therapy.
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主动脉瓣置换术的即时和晚期并发症
先天性主动脉二尖瓣可在早期迅速发展为严重的主动脉疾病,伴有明显的狭窄和反流。因此,心血管手术联合机械主动脉假体植入是唯一的治疗方案。尽管手术成功,但并发症可能很多,尤其是术后,如传导障碍和心律失常。此外,鉴于最近的指南建议将INR值维持在2,5以上,慢性口服抗凝对于长期预防心脏栓塞事件至关重要。因此,我们在此报告一位被诊断为二尖瓣主动脉瓣继发严重主动脉疾病的患者,他接受了本特尔手术,后来出现了广泛的并发症,包括即时和晚期,特别是由于长期的亚治疗INR值。该病例的特殊性在于以特定时间顺序发生的众多并发症和抗凝治疗的干扰机制。
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