[Valve Re-replacement Combined with Patch Enlargement of the Aortic Annulus for Bioprosthetic Valve Deterioration;Report of a Case].

A 42-year-old woman had undergone aortic valve replacement with a 19 mm bioprosthetic valve for aortic stenosis due to a bicuspid valve 8 years before. She was admitted to our hospital for valve re-replacement owing to the prosthetic valve dysfunction. As the patient's valve annulus was markedly thickened owing to pannus formation, we were unable to pass a 19 mm valve sizer through the annulus even after removal of the prosthetic valve and the tissue surrounding the annulus. Valve re-replacement combined with patch enlargement of the aortic annulus was performed to obtain maximally effective orifice area. Her postoperative course was uneventful, and echocardiography revealed no perivalvular leak. In valve re-replacement, it is important to remove the prosthetic valve and the tissue surrounding the annulus to the greatest extent possible and consider patch enlargement of the aortic annulus to avoid patient-prosthesis mismatch in a patient with a small aortic annulus.

[Open Heart Surgery to Remove an Ablation Catheter Entrapped in the Left Ventricle;Report of a Case].

A 66-year-old man underwent catheter ablation for Wolff-Parkinson-White syndrome. When we advanced the ablation catheter clockwise in the left ventricle, it was entrapped and became unable to control. Thus, the patient underwent open heart surgery for catheter removal. During the surgery, the last few millimeters of the catheter were observed entrapped by multiple basal chordae of the posterior mitral valve. We released the catheter safely, and visual inspection of the left ventricle showed no abnormalities. His postoperative course was uneventful. Ablation catheter entrapment in the heart is a rare but severe complication that requires open heart surgery.