Giant Aneurysm of Ascending Aorta Caused by Chronic Stanford Type A Aortic Dissection with Bicuspid Aortic Valve

Abstract

An 82-year-old male patient was admitted to our clinic because of shortness of breath and chest pain. A grade 4/6 diastolic murmur was heard on auscultation. Physical examination revealed signs of congestive heart failure and poor peripheral perfusion. There was a diagnosis of acute Stanford Type A ascending aortic dissection in the history of the patient. The patient had refused emergency surgical intervention three years ago. Computed tomography revealed chronic Stanford Type A dissection and dilatation of the ascending aorta. The patient had 2°-3° aortic insufficiency and calcified bicuspid aortic valve in an echocardiography, was detected 90 mmHg aortic valve gradient. Graft replacement of the ascending aorta and serape aortic valve replacement were performed successfully under a cardiopulmonary bypass (using both femoral and innominate artery with a Y-shaped connector) with open aortic technique. The patient was discharged on the 10 th postoperative day without any problem.