Modified Danielson technique for recurrent aortic valve endocarditis.

Recurrent aortic valve endocarditis is frequently associated with paravalvular ring abscess that destroys the annulus. In occasional cases, the degree of necrosis, destruction of the annulus, and the presence of intramyocardial abscesses make it impossible to seat a new prosthesis. Danielson reported initial success in treating such patients by translocating the aortic valve to the ascending aorta and placing vein grafts to the coronary arteries. We recently treated a 17-year-old patient suffering recurrent aortic valve endocarditis using Danielson's technique, which we modified by implanting the left main coronary artery directly into the conduit. We believe that in young patients this modification can offer a beneficial alternative.