Case study

Biographic data
The patient is a 15-year old male who was diagnosed to
have heart disease with mitral and aortic valve
regurgitation .
The patient was operated upon in 2011 and underwent
Repair of both valve. At that same time it was felt that
his pathology was degenerative rather than rheumatic.

The patient was referred to the cardiac surgery and

electively admitted for redo aortic valve or replacement.

Echocardiography
Interpretation summary :
Rhythm : sinus bradycardia HR 52.
LV moderately dilated
RV normal
AV post repair
MV post repair
Note : Gradual increase in LV diameters.

Echocardiography
Aortic valve :
The aortic valve is trileafelt. Post repair
.double contour RCC .no hemodynamically
significant valvular aortic stenosis. Moderate
to severe aortic regurgitation .there is an
eccentric jet of aortic insufficiency directed
against the anterior mitral leaflet. Diastolic
backflow descending aorta .

Echocardiography
Pulmonic valve :
The pulmonic valve leaflet are thin and pliable;
valve motion is normal . Trace pulmonic valvular
regurgitation .

Blood result :
Hemoglobin : L 103
Wbc : 9.81
Rbc : L 3.87
K : 4.6
Na : 137
Mg : 0.79

Medication :
aldactone 25 mg o.d.
Lasix 20 mg b.i.d.
Omeprazole 20 mg.
Acetaminophen for pain and fever.
Acetysalicylic acid 81 mg
Enalapril 5 mg q.d.

Preoperative diagnosis :
Sever recurrent aortic valve regurgitation
Status post mitral valve repair and aortic
Valve repair.

Postoperative diagnosis :
Sever recurrent aortic valve regurgitation
Status post mitral valve repair and aortic
Valve repair.

Operations performed
Redo sternoyomy and aortic valve
replacement utilizing the pulmonary
autograft ( Ross procedure ).
The right ventricular to pulmonary artery
continuity was reestablished utilizing a size
#23 mm cryopreserved pulmonary
homografit.