A 30-year-old woman came to the hospital with

progressive breathlessness during physical activity

Further evaluation, including echocardiography, showed that the mechanical valve was not functioning properly. One leaflet of the valve was not moving normally, and the pressure across the valve was significantly increased. The patient also had a

small aortic valve annulus and root

A Complex Redo Procedure

The surgical team performed a

redo aortic valve replacement along with aortic root enlargement

After safely reopening the chest and establishing cardiopulmonary bypass, the dysfunctional mechanical valve was removed. Because of the small size of the aortic annulus, the surgeons performed

aortic root enlargement using the Yang (Y-incision/Bo Yang) technique

A Dacron patch was used to reconstruct and enlarge the aortic root, increasing the annular size by two valve sizes. This allowed the surgical team to successfully implant a

21 mm bioprosthetic tissue valve

Successful Outcome

The patient was successfully weaned from cardiopulmonary bypass, and postoperative echocardiography showed

significantly improved valve function

Importantly, her

breathlessness during exertion completely resolved

The use of a tissue valve also meant that she could avoid lifelong warfarin therapy associated with a mechanical valve. This was particularly relevant to her future pregnancy plans.

Key Takeaway

This case highlights how a

complex redo valve surgery combined with aortic root enlargement