Transaortic double valve replacement with total chordal preservation

Very few cases of transaortic double valve replacement have been reported in the literature. A 26-year-old man presented to us with severe aortic regurgitation, mitral valve thickening, and mild mitral regurgitation 6 years after he had undergone a Ross procedure and open mitral commissurotomy. At his 2nd operation, he underwent transaortic double valve replacement with total chordal preservation of the mitral apparatus. Due to recurrent rheumatic activity, this patient had experienced a recurrence of valvulopathy Because we have observed this in other young patients with rheumatic heart disease, we no longer perform the Ross procedure in such patients, especially if there is associated mitral valve disease. In selected patients with dilated aortic annulus, the transaortic approach provides excellent access for safe mitral valve replacement with total chordal preservation. The surgical technique and a brief review of the literature are presented.