FLORIDA SLEEVE PROCEDURE FOR ROOT STABILIZATION FOLLOWING BICUSPID AORTIC VALVE REPAIR - A CASE REPORT
Kenneth Seastedt, M.D., Christopher J. Scheiber, M.D., Junewai L. Reoma, M.D..
Walter Reed National Military Medical Center, Bethesda, MD, USA.
Background: Aortic valve disease can result from a variety of etiologies including endocarditis, congenital abnormalities, and age related degenerative disease. In correcting this disease, the current gold standard is complete valve replacement with prosthesis. However, aortic valve repair instead of replacement in order to avoid the prosthesis-related complications can be considered. With this procedure aortic root stabilization is recommended and currently accomplished by complete root reconstruction which is an intricate procedure requiring a complex technique and coronary re-implantation. Therefore, in this case report we present a patient with a bicuspid aortic valve with regurgitation and aortic aneurysm who underwent aortic valve repair and root stabilization with the Florida Sleeve Procedure. Methods: Patient is an otherwise healthy 59 yo M who was found to have aortic aneurysm and bicuspid valve disease with regurgitation. Operation was aortic valve repair and root stabilization completed by Florida Sleeve Procedure. Valve repair was accomplished using simple plication of redundant prolapsed leaflet. The Florida Sleeve technique allowed for flexibility in resuspension of the commisures to optimize leaflet coaptation. Results: The patient recovered well. Post-operative echocardiogram showed resolution of aortic valve regurgitation and decrease in the diameter of his aortic root. Conclusions: This case report presents a novel approach to bicuspid aortic valve disease with the goal of reducing complications and improving reproducibility through a simplified approach. Valve repair was chosen over complete replacement in order to reduce the risk of prosthesis related complications. Root stabilization was accomplished through the Florida Sleeve procedure.
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