[A successful case of localized aortic dissection associated with bicuspid aortic valve]

It is known that bicuspid aortic valve is a risk factor of aortic dissection in Europe and America, but there is no report of the case in Japan. A 47-year-old male teacher of senior high school had an abrupt onset of chest pain. Aortogram showed localized dissection of the ascending aorta and moderate degree of aortic regurgitation. Cold cardioplegic arrest with moderate systemic hypothermia was used under cardiopulmonary bypass. The aortic valve was bicuspid and localized transverse intimal dissection was also found above left-sided commissure. As both cusps were soft and not degenerative, mattress sutures were used to support the prolapsed cusps against the outer aortic wall. The ascending aorta was replaced with a prosthetic vascular graft. Postoperative clinical course was uneventful and he is doing well two years after the surgery. The bicuspid aortic valve and aortic dissection were also discussed.