Bentall procedure in a patient with severely calcified "porcelain" aorta

Patients with severe calcified "porcelain" aorta carry a high operative risk during cardiac surgery. We report the successful case of Bentall procedure in a patient with severe porcelain aorta. A 65-year-old woman was diagnosed with aortic prosthetic valve failure and enlargement of the ascending aorta. Preoperative chest X-ray and computed tomography scan revealed heavy calcification throughout the aorta. At operation, cardiopulmonary bypass was established through the right axillary artery. The calcified aorta was transected by an oscillating saw under hypothermic circulatory arrest. Distal anastomosis was performed after endarterctomy of the calcified plate, which allowed us to complete the Bentall procedure without the postoperative bleeding.