Valve-sparing Root Reimplantation for Stanford Type A Acute Aortic Dissection Combined with Aortic Root Dilation and Bicuspid Aortic Valve;Report of a Case Masafumi Kudo 1 , Kazuhiro Yamazaki 1 , Jiro Sakai 1 , Masahide Kawatou 1 , Kazuhisa Sakamoto 1 , Takashi Fukushima 1 , Ryo Yamamoto 1 , Yujiro Ide 1 , Hideo Kanemitsu 1 , Tadashi Ikeda 1 , Kenji Minatoya 1 1Department of Cardiovascular Surgery, Kyoto University Keyword: bicuspid aortic valve , Stanford type A acute aortic dissection , valve-sparing root replacement , aortic stenosis pp.936-939
Published Date 2020/10/1
DOI https://doi.org/10.15106/j_kyobu73_936
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A 45-year-old male developed Stanford type A acute aortic dissection combined with aortic root dilation and congenital bicuspid aortic valve (BAV). He had a Sieveres type 0 BAV, lateral subtype with right and left cusps. Valve-sparing root reimplantation was performed with decalcification of the cusps. Transthoracic echocardiography (TTE) at discharge revealed no aortic regurgitation, and peak velocity of BAV was 2.15 m/second, mean pressure gradient was 9.6 mmHg and aortic valve area was 2.15 cm2. TTE after 6 months revealed only slight elevation of the peak velocity to 2.78 m/second. To perform successful reimplantation in the case of BAV, anatomic orientation of the cusps should be approximately at 180° and the tissue of the cusps should either be normal or have only minor abnormalities. Valve-sparing root reimplantation for BAV needs a careful follow-up for progression of the aortic valve dysfunction.

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