A Case of Acute Aortic Dissection after Aortic Valve Replacement for Aortic Stenosis

概要

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A 63-year-old man who underwent aortic valve replacement (AVR) for aortic stenosis (AS) associated with mildly dilated ascending aorta 28 months previously was admitted to our hospital because of severe chest pain. Computer tomography showed aortic dissection expanding from the sinus of Valsalva to the abdominal aorta. Bentall's procedure and ascending aorta-aortic arch replacement were successfully performed and his postoperative course was uneventful. The surgical management of patients with aortic stenosis associated with ascending aortic dilatation is a controversial issue. We think that Bentall's procedure may be considered as one of the strategies for AS associated with moderate dilation of the aortic root (≥50mm diameter). Following AVR, we should have regularly controlled the patient by ultrasonic cadiogram (UCG) and electively reperformed Bentall's procedure when progression of the enlargement of aortic root had been detected.
特定非営利活動法人日本心臓血管外科学会の論文