Redo aortic valve replacement with ''porcelain'' aorta in an aortitis patient. A case report

We report a successful reoperation of aortic valve replacement with the severely calcified, ''porcelain'' aorta due to Takayasu's disease. The patient was a 46-year-old female diagnosed with aortic prosthetic valve failure. Takayasu's aortitis had been noted at 17 years old and the patient underwent aortic valve replacement for aortic regurgitation at age 32. Chest CT scan revealed severe circumferential calcification of the whole thoracic aorta. Echocardiography revealed 100 mmHg of pressure gradient across the aortic prosthetic valve with pannus formation. Replacement of the aortic prosthetic valve was performed using the selective cerebral perfusion method under deep hypothermia. The postoperative course was uneventful without any neurological disorder. Selective cerebral perfusion was a useful method to avoid cross clamping in severely calcified ascending aortic.