PMC8143720_01
Endoscopic pictures showing angiodysplasia (yellow circle) in (a) and multiple argon coagulation treatment spots in (b).
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She underwent clipping and argon plasma coagulation at multiple sites (Fig. 1).
Preoperative Transthoracic Echocardiography showing severe calcified aortic valve in (a), a narrow LVOT gradient and AV area in (b) and narrow Increased AV gradient in (c).
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Hg, Aortic valve area 0.8 cm2, left ventricular outlet diameter 1.9 cms and left ventricular ejection fraction of 62% (Fig. 2). Her subsequent investigations including molecular genetic analysis for Von Willebrand factor (VWF) gene was negative.
Postoperative transthoracic Echocardiography showing Decline in postop LVOT gradient in (a) and decline in AV gradient in (b).
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Patient underwent aortic outlet myomectomy and Bentall procedure with Medtronic freestyle 25 size porcine valve under cardiopulmonary bypass (see Fig. 3).