Case report

Safe wrapping of the borderline dilated ascending aorta during aortic valve replacement

Ernesto Tappainer¹ , Vinicio Fiorani¹ , Andrea Nocchi¹ , Ermal Likaj² , Sabjan Memishaj² and Mario Zogno¹

¹  Cardiac Surgery Unit, "Carlo Poma" Hospital, Viale Albertoni 1, 46100 Mantua, Italy

²  Cardiovascular Department, University Hospital Center "Mother Teresa", Rruga e Dibres 372, Tirana, Albania

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Journal of Cardiothoracic Surgery 2007, 2:15doi:10.1186/1749-8090-2-15

Published:	22 February 2007

Abstract

Background

Techniques of reduction aortoplasty are widely published in the literature with conflicting results. External support seems to be an important factor in preventing recurrence but, in some cases, this technique caused erosion of the aorta because of the wrinkles the prosthesis creates in the rear side of the aorta.

Case presentation

A 73 year old patient with aortic valve stenosis and borderline dilated ascending aorta had aortic valve replacement and simple wrapping without aortoplasty. To avoid the formation of wrinkles, the dacron external support was tailored appropriately to obtain a curved, custom-made prosthesis. This custom-made prosthesis had the same diameter as the dilated aorta and, after valve replacement, fitted it properly. After 18 months neither computerized axial tomography nor ecocardiography detected wrinkles or dilatation recurrence.

Conclusion

A safe, simple and probably new way to prepare an external wrapping is presented, which in this patient respected the shape of the aorta and prevented the formation of wrinkles in the prosthesis and possible complications such as wall erosion.