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

European Heart Journal - Case Reports

10 September 2024
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ESC Journals DISEASES OF THE AORTA, PERIPHERAL VASCULAR DISEASE, STROKE Diseases of the Aorta IMAGING Echocardiography VALVULAR, MYOCARDIAL, PERICARDIAL, PULMONARY, CONGENITAL HEART DISEASE Valvular Heart Disease

Abstract

AbstractBackground

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.