A Successfully Operated Case of Annulo-Aortic Ectasia with Acute A Type Aortic Dissection / 日本心臓血管外科学会雑誌

ABSTRACT

A 64-year-old woman, with no findings of Marfan's syndrome, was addmited with dyspnea on exsertion. She had a family history of thoracic aortic disease. Moderate aortic regurgitation was diagnosed due to mild annulo-aortic ectasia (AAE) limited in the sinuses of Valsalva with moderately impaired left ventricular function. The aortography showed that the diameters of the ascending aorta, the aortic root, and the aortic ring were 38mm, 48mm, and 23.5mm. We planned aortic valve replacement, as the AAE was small and was limited in the sinuses of Valsalva, but she sufferd from A type acute dissection combined with AAE, while waiting for operation. As she fell into deep shock and cardiac arrest caused by cardiac tamponade, an emergency operation was done. The intimal tear was found in the ascending aorta, but no organic change was seen on the three cusps of the aortic valve. Total aortic root replacement with Cabrol's procedure was performed successfully. We recommend that AR with AAE should be performed with aortic root reconstruction in such cases because AAE is often combined with aortic root dissection, even if the aortic root size is small.