Composite graft tear and aortico-left ventricular tunnel after aortic root replacement using Cabrol's technique

Woven graft tera is a very rare complication after aortic root replacement using Cabrol's technique. In this report, we present a 40-year-old man with aortic annular ectasia and severe aortic regurgitation who underwent four revisional aortic valve operations because of recurrent paravalvular leakage after valve repair and/or replacement. The Bentall operation with translocated aortic valve and Cabrol's coronary artery anastomosis were performed in the fifth operation, because of progressive dilatation of the aortic root and ascending aorta. Unfortunately, aortico-ventricular tunnel developed 2 years after aortic root replacement using Cabrol's technique. Graft tear and proximal anastomotic leakage were found to be the cause of the tunnel during the sixth operation. The patient died of myocardial failure 8 days after the seventh aortic root replacement operation. The devastating result of this complication should alert cardiovascular surgeons to the possibility of graft failure after the Bentall operation.