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Aortic dissection one year after aortic valve replacement

Ali Asgar Behranwala1, Shyam R Handa2, Nihar P Mehta3

  • 1Department of Cardiovascular Thoracic Surgery, Jaslok Hospital and Research Centre, Mumbai, India.

Asian Cardiovascular & Thoracic Annals
|June 3, 2014
PubMed

Insights

Acute aortic dissection is a rare complication following aortic valve replacement. This case highlights the importance of assessing aortic root diameter and wall integrity to prevent dissection, especially after previous surgery.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Aortic Surgery

Background:

  • Aortic valve replacement (AVR) is a common cardiac procedure.
  • Acute aortic dissection is a rare but serious complication post-AVR.
  • Previous aortotomy can be a predisposing factor for aortic dissection.

Observation:

  • A 57-year-old male developed acute type A aortic dissection 1 year after AVR.
  • The dissection originated from the previous aortotomy site.
  • The patient underwent a Bentall procedure and developed complete heart block postoperatively.

Findings:

  • Assessing aortic diameter and wall characteristics is crucial during AVR.
  • Aortic root diameter >45 mm warrants consideration for prophylactic aortic root replacement.
  • This case underscores the risk of dissection at prior surgical sites.

Implications:

  • Preoperative risk stratification for aortic dissection is essential in AVR candidates.
  • Consideration of prophylactic aortic root repair may reduce dissection risk.
  • Surgeons must be vigilant for dissection in patients with a history of aortic surgery.

Keywords:
Aortic dissectionBentall procedureaortic aneurysmcomplete heart blockpacemakerpost aortic valve replacement

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