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(Circulation. 2003;107:3108.)
© 2003 American Heart Association, Inc.

Images in Cardiovascular Medicine

Left Ventricular Apicoaortic Conduit

A Cause of an Unusual Position of a Prosthetic Valve

John Lynn Jefferies, MD, MPH; Roberto Lufschanowski, MD; Denton A. Cooley, MD

From the Cardiovascular Department, St. Luke’s Episcopal Hospital and The Texas Heart Institute, Houston, Tex.

Reprint requests to Roberto Lufschanowski MD, 6624 Fannin, Suite 2780, Houston, TX 77030.

This 45-year-old woman had a history of congenital hypoplasia of the left ventricular outflow tract. She underwent repair of the outflow tract performed by D.A.C. in 1964. At age 19, she had severe aortic stenosis and a very small aortic annulus. A 19-mm Hancock (porcine valve) conduit was placed between the left ventricular apex and the supraceliac abdominal aorta. At age 29, she was restudied and found to have a 120-mm Hg gradient between the left ventricle and the conduit. The conduit was replaced with an 18-mm Hancock graft. She has done well for the last 16 years (Figure).

View larger version (86K): [in this window] [in a new window]   Posteroanterior (A) and lateral (B) chest radiographs showing abdominal position of the Hancock valve with normal heart size and clear lung fields.

The presence of a prosthetic heart valve in the abdomen should be the clue to the diagnosis of a previous apicoaortic conduit.

Footnotes

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Jefferies, J. L. Articles by Cooley, D. A. Search for Related Content PubMed PubMed Citation Articles by Jefferies, J. L. Articles by Cooley, D. A. Related Collections Catheter-based coronary and valvular interventions: other