Florida sleeve technique for a right sinus of Valsalva aneurysm: a case report

Kosuke Saku,Atsunobu Oryoji,Hiroyuki Saisho,Tomofumi Fukuda,Tohru Takaseya,Yasuyuki Zaima,Hiroyuki Tanaka,Satoru Tobinaga,Kazuyoshi Takagi,Takahiro Shojima

doi:10.1186/s40792-019-0682-x

Abstract

BackgroundFlorida sleeve technique was reported by Hess et al. as a new technique of valve sparing aortic root replacement without the requirement of entire aortic root wall resection and coronary artery reconstruction. We present a rare case of an unruptured aneurysm of the right sinus of Valsalva that was successfully treated with resection of the aneurysm and the Florida sleeve technique.Case presentationA 72-year-old man was admitted for the treatment of an unruptured aneurysm of the right sinus of Valsalva. Computed tomography showed an aneurysm of the right sinus of Valsalva measuring > 40 mm and protruding into the right ventricular outflow tract. The aneurysm dilated up to 5 mm per year, and the left sinus of Valsalva and non-coronary sinus of Valsalva also showed dilation, and he underwent resection of only the right sinus of Valsalva aneurysm and valve sparing aortic root replacement with the Florida sleeve technique.ConclusionsWe performed valve-sparing aortic root replacement with the Florida sleeve technique. It could reduce surgical risks and prevent a dilatation of the residual sinus of Valsalva through coverage with a graft for a long term.

Highlights

Florida sleeve technique was reported by Hess et al as a new technique of valve sparing aortic root replacement without the requirement of entire aortic root wall resection and coronary artery reconstruction
Florida sleeve technique (FST) was reported by Hess et al [2] as a new technique of valve-sparing aortic root replacement (VSARR) without the requirement of entire aortic root wall resection and coronary artery reconstruction
We present a rare case of an unruptured aneurysm of the right sinus of Valsalva (RSV) that was successfully treated with resection of the aneurysm and FST

Summary

Background

A sinus of Valsalva aneurysm (SVA) is a relatively rare cardiovascular disease. Generally, an unruptured but symptomatic or enlarging SVA should be considered for surgical intervention [1]. Case presentation A 72-year-old man was admitted to a hospital for dizziness, and an unruptured right SVA was observed on transthoracic echocardiography. On the CT and coronary angiography, neither the coronary cameral fistula nor the rupture of the aneurysm into the right ventricle or right atrium was observed He was diagnosed with an unruptured right SVA and was scheduled for surgery. CT showed no distortion or stenotic region associated with the covered graft at the left main coronary artery trunk, and the sinus of Valsalva measurements was mm (RSV), mm (LSV), and 26 mm (NCSV) (Fig. 3)

Discussion

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Conclusion