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Aortic root and aortic valve replacement using two prosthesis: bioprosthesis and Dacron tube in 47-year-old male. Case report

Author(s): Maciej Rachwalik | Josephine Wright | Vaja Chandrasekaran

Journal: Polish Journal of Cardiology
ISSN 1507-5540

Volume: 10;
Issue: 3;
Start page: 248;
Date: 2008;
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Keywords: ascending aorta | aneurysm | prosthesis | bicuspid aortic valve | connective tissue disorder |

We present the case of 47 year old male with mild inherited collagen deficiency who underwent complex aortic root and ascending aorta replacement. Preoperative transthoracic echocardiogram (2-D, M-mode, Doppler and colour Doppler) revealed a dilated aortic root: sinus of valsalva 4.3 cm; aortic annulus 3.0 cm; sinotubular junction 4.0 cm. Ascending aorta was also dilated (4.5 cm), and aortic arch was narrowed to 3.0 cm.The aortic valve was bicuspid with severe aortic regurgitation. A porcine stentless xenograft was used to replace the aortic root, and bio-prosthesis was used to reconstruct the ascending aorta. The optimal device to replace the aortic valve and ascending aorta en-block is controversial. This method was favoured, given the patients young age, active lifestyle and desire not to undergo anticoagulation. We describe briefly our technique, including our methods of myo-cardial protection. We also discuss the current literature regarding surgical techniques for repair of the dilated aortic root and ascending aorta.

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