Trushar GAJJAR, Neelam DESAİ, Channabasavaraj HİREMATH, Nageswar RAO

Intermittent dysfunction of prosthetic aortic valve causing acute coronary syndrome

Protez aort kapakçığının intermitan disfonksiyonu nadir, fakat saptanması güç olabilen yaşamı tehdit eden bir durumdur. Klinik tablo kendini yük/perfüzyon dengesiz-liğine bağlı şiddetli bir akut iskemi veya kalp yetmezliğiolarak gösterebilir. Bu yazıda inen aort anevrizması ile birlikte biküspid aort kapakçık stenozu nedeniyle beş yıl önce Bentall ameliyatı yapılan, protez aort kapakçığındaintermitan disfonksiyon olan 37 yaşında bir kadın olgu sunuldu. Elektrokardiyografide aVR ve V1 derivasyon-larda geçici ST yükselmesinin eşlik ettiği sinüs taşikardi ve I, II, III, aVF ve V3-V6 derivasyonlarında ST çökmesiizlendi. Fizik muayene ve laboratuvar sonuçları normalolmakla birlikte, transtorasik ekokardiyografide sol anaostiumun yakınındaki kapaktan köken alan flep benzeri pannus izlendi. Koroner anjiyografide koronerler normal-di. Hastaya ameliyat planlandı ve pannus eksize edildi.Ameliyat sonrası dönem sorunsuzdu.

Akut koroner sendroma neden olan protez aort kapakçığının intermitan disfonksiyonu

Intermittent dysfunction of prosthetic aortic valve is arare, but life-threatening condition which may be difficultto recognize. The clinical presentation, include a severeacute ischemia due to the load/perfusion mismatch or heartfailure. In this article, we report a case of intermittentdysfunction of prosthetic aortic valve in a 37-year-oldfemale case who underwent Bentall operation five yearsago for bicuspid aortic valve stenosis with ascendingaortic aneurysm. An electrocardiogram showed sinustachycardia with transient ST elevation in leads aVR andV1 and ST depression in leads I, II, III, aVF and V3-V6.Physical examination and laboratory results were normalbut transthoracic echocardiography showed, a flap likepannus arising from the valve near the left main ostium.Coronary angiography showed normal coronaries. Thepatient was scheduled for surgery and a pannus wasexcised. Postoperative course was uneventful.

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