Key result
Bentall procedure treats acute type A aortic dissection at a prior aortotomy site 1 year post-AVR.
Why the study?
Acute aortic dissection after aortic valve replacement is rare and risk factors during surgery need assessment to guide prophylactic measures.
Case Report (n=1)
Acute type A aortic dissection can occur at the previous aortotomy site after aortic valve replacement, highlighting the importance of assessing aortic root diameter and considering prophylactic replacement if >45 mm.
Attention to aortic wall fragility during AVR may reduce late dissection risk; single case leaves open optimal preventive strategies.
Acute aortic dissection after aortic valve replacement is rare. A 57-year-old man presented with an acute type A aortic dissection 1 year after aortic valve replacement, which originated from the previous aortotomy site. He underwent a Bentall procedure. Postoperatively, he developed complete heart block requiring permanent pacemaker implantation. During aortic valve replacement, risk factors for aortic dissection (diameter of the aorta and fragility and thinness of the aortic wall) should be assessed. Prophylactic aortic root replacement should be undertaken if the aortic root is more than 45 mm in diameter.
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Behranwala et al. (2013) conducted a case report in Acute type A aortic dissection after aortic valve replacement (n=1). Bentall procedure was evaluated. A 57-year-old man underwent a Bentall procedure for an acute type A aortic dissection originating from a previous aortotomy site 1 year after aortic valve replacement.
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