[Aortic root replacement as redo operation]

Aortic root replacement (ARR) after aortic valve replacement (AVR) or ARR is often a major challenge. We performed 12 cases (7 men and 5 women) of ARR as redo operation from July 2002 to June 2009 in our institution. There was no mortality. Among them. ARR was performed in 5 cases, and AVR in 6 cases, at the previous operation. The age at the redo operation was 59.6 +/- 12.7 years. The mean interval between the previous and the redo operations was 6.8 years. In the cases of previous AVR, enlargement of the aortic root or the Valsalva sinus was recognized in 3, artificial valve failure with pannus formation below the valve was in 2, and perivalvular and regurgitation with infection was in 1. In the cases of previous ARR, surgical site infection was seen in 4, among which pseudoaneurysm formation or bleeding from the suture line at the aortic root was the reason for the redo operation in 3 cases. Pseudoaneurysm formation and artificial valve failure may be involved in some type of infection. ARR may be necessary in patients with aortitis.