Page 84 - BH-2-1

Brain & Heart

CASE REPORT
Completion Bentall procedure for a huge aortic

root pseudoaneurysm after surgery for acute
aortic dissection: A case report

Hisato Ito*, Satoshi Maruyama, Takato Yamasaki, Saki Bessho, Shuhei Toba,
Yu Shomura, and Motoshi Takao
Department of Thoracic and Cardiovascular Surgery, Mie University Hospital, 2-174 Edobashi, Tsu,
Mie, 514-8507, Japan

Abstract
A 56-year-old man with a history of emergency ascending aortic and aortic valve
replacement for acute type A aortic dissection 6 months previously developed a huge
pseudoaneurysm arising from the sinus of Valsalva due to recurrent aortic root dissection.
The patient urgently underwent the completion Bentall procedure with coronary artery
reconstruction using interposing grafts. During surgery, the non-coronary sinus of Valsalva
was repeatedly dissected and ruptured, where surgical glue was applied in the previous
operation. The 25-mm REGENT mechanical valve from the previous operation was left in
®
place, and 2-0 bladed mattress sutures were circumferentially placed in the sewing ring of
the prosthesis. A 28-mm Valsalva graft was cut at the middle of its skirt portion, through
®
which these sutures were passed and tied, and was seated to completely cover the valve
*Corresponding author: cuff. The completion Bentall procedure is considered a feasible technique for reoperative
Hisato Ito aortic root replacement in patients with a prosthetic aortic valve following acute type A
(hisato.ito@gmail.com) aortic dissection repair. It is important to accurately measure the outer diameter of the
Citation: Ito H, Maruyama S, prosthetic valve to ensure proper fit of the graft and to minimize the risk of bleeding.
Yamasaki T, et al. Completion
Bentall procedure for a huge aortic
root pseudoaneurysm after surgery Keywords: Aortic dissection; Reoperation; Aortic root aneurysm; Aortic valve; Sinus
for acute aortic dissection: A of Valsalva
case report. Brain & Heart.
2024;2(1):2256.
https://doi.org/10.36922/bh.2256
Received: November 15, 2023
1. Background
Accepted: January 23, 2024
The completion Bentall procedure, a prosthesis-sparing operation, could be a good option
Published Online: February 16, in repeat surgery for aortic root pathology with a previously implanted prosthetic aortic
2024
valve. We experienced a case of rupture and pseudoaneurysm formation of the sinus of
1-3
Copyright: © 2024 Author(s). Valsalva due to recurrent aortic root dissection in a patient with a history of emergency
This is an Open-Access article
distributed under the terms of the ascending aortic replacement and aortic valve replacement (AVR) for acute type A aortic
Creative Commons Attribution dissection. We herein report the usefulness of the completion Bentall procedure for
License, permitting distribution, reoperative root replacement in patients with a prosthetic aortic valve following acute
and reproduction in any medium,
provided the original work is type A aortic dissection repair and the importance of proper size selection of a graft to
properly cited. minimize the risk of bleeding.
Publisher’s Note: AccScience
Publishing remains neutral with 2. Case presentation
regard to jurisdictional claims in
published maps and institutional A 56-year-old man with a history of emergency ascending aortic replacement
affiliations. and mechanical AVR for acute aortic dissection 6 months before seeking medical

Volume 2 Issue 1 (2024) 1 https://doi.org/10.36922/bh.2256