Bentall Operation in Patient with Unicuspid Aortic Valve

이재훈, 정의석

인제대학교 의과대학 상계백병원 흉부외과학교실

Background : Unicuspid aortic valve(UAV) is poorly described in the literature, occurs about 50-fold less often than bicuspid aortic valve(BAV), with an incidence of about 0.02% among patients referred echocardiography. Reported mean weights of UAV are heavier than BAV and the extension of calcification into the interventricular septum result in damage to the conduction system during debridement for aortic valve replacement(AVR). We report a case of Bentall operation in patient with UAV and ascending aortic aneurysm.

Methods : A 36 year old man was admitted due to dyspnea and chest pain for 1 month. Initial chest roentgenogram showed mediastinal widening and electrocardiogram showed 2:1 block. Transthoracic echocardiogram showed UAV with severe aortic stenosis. Computed tomogram showed aortic root (5.0 cm in diameter) and ascending aortic aneurysm(5.5 cm in diameter). Intraoperative findings showed heavy calcified unicuspid aortic valve without any commissure and raphe. Bentall operation was performed with 27mm mechanical valved conduit.

Results : The patient showed intermittent complete AV block and discharged at the 12th postoperative day. However, the patient was readmitted due to syncope at the 21th postoperative day and performed permanent pacemaker insertion.

Conclusion : UAV is a rare clinical condition. Surgeon should be keep in mind more severe extension of calcium deposit compared with BAV can cause conduction tissue injury during operation.

책임저자: 이재훈

인제대학교 의과대학 상계백병원 흉부외과학교실

연락처 : 이재훈, Tel: 02-950-1045 , E-mail : hoiseljh@hanmail.net