Concomitant giant coronary artery and coronary sinus aneurysms

Abstract

consecutive reoperations were needed because of recurrent prosthetic dehiscence and mitral valve dysfunction. It was considered that a mitral homograft could be a valid alternative, but functional results were disappointing because of limited mobility and deficient coaptation of the anterior leaflet. Implantation of an annuloplasty ring and repair of the valve commissure were unsuccessful, and instead of explanting the homograft it was decided to remove the annuloplasty ring and insert a bioprosthesis in a transvalvular position, with the homograft acting as a native valve. At 14 months of follow-up, the patient is free of symptoms, and functional results are satisfactory. Hypersensitivity to the suture ring of the valve prosthesis is an appealing explanation for our findings. In this respect, the interposed homograft avoided the potential risk of intolerance to the suture ring and also prevented direct contact between the infected tissue and the prosthesis.