Aortic root reimplantation using a Valsalva graft for postoperative pseudoaneurysm after acute aortic dissection

We report a reoperative case in which a Valsalva graft was utilized on a 64-year-old woman who had previously undergone emergency repair of a DeBakey type I acute aortic dissection. On follow-up computed tomography (CT), she was found to have pseudoaneurysms of both proximal and distal anastomoses. We performed valve-sparing aortic root replacement (VSRR) with the reimplantation technique and total arch replacement, since we felt that a graft with pseudosinuses helps to prevent torsion of the coronary arteries. The postoperative course was uneventful, and postoperative echocardiography revealed no significant aortic valve regurgitation. The pathology results raised the hypothesis that pseudoaneurysm formation might have been related to the use of gelatin-resorcinol-formaldehyde (GRF) glue at the time of the initial intervention.