Apicoaortic bypass for a patient with structural valve deterioration of a 19 mm bioprosthetic valve

We herein report a case of apicoaortic bypass (AAB) in a 79-year old patient presenting with structural valve deterioration who had undergone an aortic valve replacement with a 19 mm bioprosthetic valve and aortocoronary (A-C) bypass grafting 4 years prior to the AAB. Considering the small diameter of the aortic annulus, the existence of a previous A-C bypass and the high risk of reoperation, we selected implanting an AAB. The postoperative course was uneventful. The postoperative haemodynamics were evaluated using phase-contrast cine magnetic resonance imaging. It demonstrated that 58% of ventricular outflow was directed through the valved conduit. It showed that no obvious stagnation of the blood flow occurred during the entire cardiac cycle.