Left Ventricular Apicoaortic Conduit
A Cause of an Unusual Position of a Prosthetic Valve
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).
The presence of a prosthetic heart valve in the abdomen should be the clue to the diagnosis of a previous apicoaortic conduit.
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.
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