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Received Oct 1, 2017; Accepted Jan 1, 2018
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1. Introduction
Aortitis is an infrequent cause of aortic root dilatation and aortic valve regurgitation, having been described several infectious and noninfectious etiologies for this yet not well-known entity [1]. The approach to the “valvular problem” is controversial, having been reported increased rates of paravalvular leaks with prosthetic replacement [2]. Valve-sparing procedures have also been proposed [3], but there is not clear evidence of which is the treatment of choice.
2. Case Presentation
We report the case of a 38-year-old pregnant lady with a diagnosis of idiopathic aortitis associated with aortic root aneurysm and severe aortic valve regurgitation.
The patient had a history of cardiac murmur, having had an echocardiogram performed two years before the episode showing a mild mitral regurgitation with a normal aortic valve and aorta. She was asymptomatic until the 4th month of pregnancy when she began with tachycardia and exertional dyspnea which rapidly evolved to rest dyspnea; she was admitted to the hospital, and an echocardiographic study was performed, showing a very severe aortic regurgitation and a 5.5 cm aneurysm of the root and ascending aorta; the left ventricle was markedly dilated with a borderline ventricular fraction. No computed tomography scan was done to avoid potential damage to the fetus.
She was transferred to our unit for urgent surgery for a planned valve-preserving surgery.
She was operated on under general anesthesia and median sternotomy. The aortic arch and the right atrium were cannulated in a standard fashion, and cardiopulmonary bypass (CPB) was established under normothermia. CPB flows were kept high maintaining a mean arterial pressure above 70 mmHg, and the use of vasoconstrictors was avoided [4, 5].
The aorta...