Valve surgery in octogenarians with a "porcelain" aorta and aortic insufficiency

We report the technique of balloon occlusion of the ascending aorta in two patients requiring valve operations. In the first patient, it provided a rapid solution to unexpected and potentially catastrophic severe aortic insufficiency (AI) with the initiation of cardiopulmonary bypass in a patient who required aortic valve replacement using deep hypothermic circulatory arrest due to a "porcelain" aorta. In the second patient, it allowed for a routine mitral valve repair to be performed by providing aortic occlusion in the setting of AI and avoiding the devastating consequences of cross-clamping a "porcelain" aorta.