Redo-Aortic Root Aneurysm

Abstract

OBJECTIVE: Prosthetic valve implantation has revolutionized the management of valvular heart disease. The original concept valve a ball in a cage is, still considered as a fascinating discovery. Reported 30-year survival rate for patients fitted with an aortic S-E ball valve was 19.9%, so the present case permitted a rare opportunity for reoperation.

METHODS: We report a case of a 63 years Chinese gentleman underwent aortic valve replacement surgery with a Starr-Edwards ball valve prosthesis 34 years ago presented to our Accident and Emergency department with pressure symptoms resulting from aortic root aneurysm.

RESULTS: The Extracted ball vale was functioning normally. Decalcification of aortic root and replacement of aortic root and ascending aorta done with 25 mm Biovalsalva Aortic Valve Bioprosthesis with tube graft inserted into annulus. Post operatively developed rate controlled AF and Culture negative Upper sternal wound discharge. Patient discharged home 21 days after surgery. The excision histology showed cystic medial degeneration.

CONCLUSION: In appropriate age group it is reasonable to explant a fully functional mechanical prosthesis during concomitant aortic root surgery to negate the need for life long anticoagulation.