Concomitant aortic arch and root replacement using a stentless xenograft for acute type a dissection

Abstract

A 78-year-old woman with an aortic root aneurysm and aortic regurgitation developing acute type A dissection successfully underwent aortic root replacement using a stentless xenograft during core cooling, followed by total aortic arch replacement under selective cerebral perfusion with deep hypothermia. This bioprosthesis can be used in the same way as a free-hand homograft and potentially provides an aggressive, safe option for acute aortic dissection requiring aortic root reconstruction in elderly patients.

Aortic Root Replacement with Stentless Xenograft for Aortic Dissection

“…The stentless xenograft also provides more reliable results compared with the aortic valve‐sparing procedure, which has risks of residual AR. In addition to these benefits, even in emergency surgery, the stentless xenograft is commercially available in a variety of sizes (9,10).…”

“…Considering these surgical standpoints, radical concomitant replacement of the aortic root and aortic arch were conducted at the time of the initial surgery (10). An appropriate myocardial protection and use of a Freestyle valve make the performance of a simultaneous operation safe, reliable, and reproducible in patients with acute aortic dissection who have severe aortic disease, especially elderly patients.…”