Skip to main content
Top
Published in: Journal of Cardiothoracic Surgery 1/2016

Open Access 01-12-2016 | Case report

A modified Park's stitch to correct aortic insufficiency for bioprosthetic valve at time of left ventricular assist device implant: a case report

Authors: Toshinobu Kazui, Nicole Sydow, Mark Friedman, Samuel Kim, Scott Lick, Zain Khalpey

Published in: Journal of Cardiothoracic Surgery | Issue 1/2016

Login to get access

Abstract

Background

Aortic valve insufficiency (AI) at the time of left ventricular assist device (LVAD) insertion needs to be corrected, however there is little known about how to manage bioprosthetic valvular AI.

Case presentation

A 55-year-old female with dilated cardiomyopathy who previously had a bioprosthetic aortic valve replacement needed a LVAD as a bridge to transplant. Her left ventricular ejection fraction was 10% and had mild to moderate transvalvular AI. She underwent a HeartWare HVAD insertion along with aortic valvular coaptation stitch repair (Park's stitch) to the bioprosthetic valve.

Conclusion

Her AI improved to trivial with minimal ejection through the bioprosthetic valve. She was transplanted 6 months following the surgery. A Park's stitch to the bioprosthetic aortic valve with more than mild AI might be a good option for bridge to transplant patient.
Literature
1.
go back to reference Rajagopal K, Daneshmand MA, Patel CB, Ganapathi AM, Schechter MA, Rogers JG, Milano CA. Natural history and clinical effect of aortic valve regurgitation after left ventricular assist device implantation. J Thorac Cardiovasc Surg. 2013;145:1373–9.CrossRefPubMed Rajagopal K, Daneshmand MA, Patel CB, Ganapathi AM, Schechter MA, Rogers JG, Milano CA. Natural history and clinical effect of aortic valve regurgitation after left ventricular assist device implantation. J Thorac Cardiovasc Surg. 2013;145:1373–9.CrossRefPubMed
2.
go back to reference Mudd JO, Cuda JD, Halushka M, Soderlund KA, Conte JV, Russell SD. Fusion of aortic valve commissures in patients supported by a continuous axial flow left ventricular assist device. J Heart Lung Transplant. 2008;27:1269–74.CrossRefPubMed Mudd JO, Cuda JD, Halushka M, Soderlund KA, Conte JV, Russell SD. Fusion of aortic valve commissures in patients supported by a continuous axial flow left ventricular assist device. J Heart Lung Transplant. 2008;27:1269–74.CrossRefPubMed
3.
go back to reference Goldstein DJ, Grady KL, Jones K, Hryniewicz K, John R, Kaan A, Kusne S, Loebe M, Massicotte MP, Moazami N, Mohacsi P, Mooney M, Nelson T, Pagani F, Perry W, Potapov EV, Eduardo Rame J, Russell SD, Sorensen EN, Sun B, Strueber M, Mangi AA, Petty MG, Rogers J, International Society for Heart and Lung Transplantation. The 2013 international society for heart and lung transplantation guidelines for mechanical circulatory support: Executive summary. J Heart Lung Transplant. 2013;32:157–87.CrossRefPubMed Goldstein DJ, Grady KL, Jones K, Hryniewicz K, John R, Kaan A, Kusne S, Loebe M, Massicotte MP, Moazami N, Mohacsi P, Mooney M, Nelson T, Pagani F, Perry W, Potapov EV, Eduardo Rame J, Russell SD, Sorensen EN, Sun B, Strueber M, Mangi AA, Petty MG, Rogers J, International Society for Heart and Lung Transplantation. The 2013 international society for heart and lung transplantation guidelines for mechanical circulatory support: Executive summary. J Heart Lung Transplant. 2013;32:157–87.CrossRefPubMed
4.
go back to reference McKellar SH, Deo S, Daly RC, Durham 3rd LA, Joyce LD, Stulak JM, Park SJ. Durability of central aortic valve closure in patients with continuous flow left ventricular assist devices. J Thorac Cardiovasc Surg. 2014;147:344–8.CrossRefPubMed McKellar SH, Deo S, Daly RC, Durham 3rd LA, Joyce LD, Stulak JM, Park SJ. Durability of central aortic valve closure in patients with continuous flow left ventricular assist devices. J Thorac Cardiovasc Surg. 2014;147:344–8.CrossRefPubMed
5.
go back to reference Park SJ, Liao KK, Segurola R, Madhu KP, Miller LW. Management of aortic insufficiency in patients with left ventricular assist devices: A simple coaptation stitch method (park's stitch). J Thorac Cardiovasc Surg. 2004;127:264–6.CrossRefPubMed Park SJ, Liao KK, Segurola R, Madhu KP, Miller LW. Management of aortic insufficiency in patients with left ventricular assist devices: A simple coaptation stitch method (park's stitch). J Thorac Cardiovasc Surg. 2004;127:264–6.CrossRefPubMed
6.
go back to reference Toda K, Fujita T, Domae K, Shimahara Y, Kobayashi J, Nakatani T. Late aortic insufficiency related to poor prognosis during left ventricular assist device support. Ann Thorac Surg. 2011;92:929–34.CrossRefPubMed Toda K, Fujita T, Domae K, Shimahara Y, Kobayashi J, Nakatani T. Late aortic insufficiency related to poor prognosis during left ventricular assist device support. Ann Thorac Surg. 2011;92:929–34.CrossRefPubMed
Metadata
Title
A modified Park's stitch to correct aortic insufficiency for bioprosthetic valve at time of left ventricular assist device implant: a case report
Authors
Toshinobu Kazui
Nicole Sydow
Mark Friedman
Samuel Kim
Scott Lick
Zain Khalpey
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2016
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-016-0555-3

Other articles of this Issue 1/2016

Journal of Cardiothoracic Surgery 1/2016 Go to the issue