A FENESTRATED AORTIC-VALVE CONTRIBUTING TO IATROGENIC AORTIC-INSUFFICIENCY POST MITRAL-VALVE REPLACEMENT

A case of an unusual local complication of cardiac valvular surgery is presented. Distortion of the geometry of the aortic valve base by a p rosthetic mitral valve sewing ring allowed aortic insufficiency throug h the aortic valve's central orifice, as well as through an aortic val ve cusp fenestration. During the 6 years after valve surgery, this pat ient developed chronic left heart failure contributed to by the aortic insufficiency and eventually, at age 65, required cardiac transplanta tion. Surgeons and pathologists should be aware of this unusual local complication of cardiac valve surgery, as it may have serious conseque nces.