Aortic Valve replacement with Reduction Aortoplasty with Mesh Prosthesis in 75 years old with Sever aortic Regurgitation with Aortic Aneurysm

Document Type : Case Report


1 Cardiac Surgeon, Department of Cardiac Surgery, Faculty of Medical Science. Mashhad University of Medical Sciences, Mashhad, Iran.

2 Cardiac Surgeon, Department of Cardiac Surgery, Faculty of Medical Science. Mashhad University of Medical Sciences, Iran.

3 Resident of Cardiac Surgery, Department of Cardiac Surgery, Faculty of Medical Science, Mashhad University of Medical Sciences, Mashhad, Iran


Although classic and standard procedure for patients with ascending Aorta aneurysm with Sever aortic Regurgitation is Bentall surgery but in some selected cases this complex surgery was not performed with different reason like advanced age and coexisting comorbidity involving renal and hepatic and lung Function. In our cases 75 years old man with chronic renal failure ( Cr= 3.2 ) who was known case of sever aortic Regurgitation and Ascending Aortic Aneurysm with 5.5 diameter.replacement of Aortic Valve with Biologic Prosthesis Aortic Valve and Reduction Aortoplasty with Mesh prosthesis was done successfully with good result with early follow up.


  1. Pomianowski P., Elefteriades J.A. The genetics and genomics of thoracic aortic disease. Ann card surg. 2013;2:271–279
  2. Wischmeijer A., Van Laer L., Tortora G., Bolar N.A., Van Camp G., Fransen E. Thoracic aortic aneurysm in infancy in aneurysms–osteoarthritis syndrome due to a novel SMAD3 mutation: further delineation of the phenotype. Am J Med Genet A. 2013;161A:1028–1035. [PubMed] [Google Scholar]
  3. Hiratzka L.F., Bakris G.L., Beckman J.A., Bersin R.M., Carr V.F., Casey D.E., Jr. ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. AnesthAnalg. 2010;111:279–315. [PubMed] [Google Scholar]
  4. Trindade P.T. Losartan treatment in adult patients with Marfan syndrome: can we finally COMPARE? Eur. Heart J. 2013 [PubMed] [Google Scholar]
  5. Benedetto U., Melina G., Takkenberg J.J., Roscitano A., Angeloni E., Sinatra R. Surgical management of aortic root disease in Marfan syndrome: a systematic review and meta-analysis. Heart. 2011;97:955–958. [PubMed] [Google Scholar]
  6.    Coady MA, Rizzo JA, Hammond GL, et al. What is theappropriate size criterion for resection of thoracic aorticaneurysms? J ThoracCardiovascSurg 1997;113:476–91.
  7. Bauer M, Grauhan O, Hetzer R. Dislocated wrap after previous reduction aortoplasty causes erosion of the ascending aorta. Ann ThoracSurg 2003;75:583–4
  8. Robicsek F. Invited commentary: tailoring aortoplasty for repair of fusiform ascending aneurysms. Ann ThoracSurg 1995;59:501
  9. Immer FF, Barmettler H, Berdat PA, Immer-Bansi AS, Englberger L, Krähenbühl ES, Carrel TP: Effects of deep hypothermic circulatory arrest on outcome after resection of ascending aortic aneurysm. Ann Thorac Surg. 2002, 74 (2): 422-425
  10. Elefteriades JA: Natural history of thoracic aortic aneurysms: indications for surgery, and surgical versus nonsurgical risks. Ann Thorac Surg. 2002, 74 (Suppl): S1877-S1880
  11. De Paulis R, Cetrano E, Moscarelli M, Andò G, Bertoldo F, Scaffa R, Tomai F, Chiariello L: Effects of ascending aorta replacement on aortic root dilatation. Eur J Cardiothorac Surg. 2005, 27 (1): 86-89.
  12. Gill M, Dunning J: Is reduction aortoplasty (with or without external wrap) an acceptable alternative to replacement of the dilated ascending aorta?. Interact CardiovascThorac Surg. 2009, 9 (4): 693-697.
  13. Ergin MA, Spielvogel D, Apaydin A, Lansman SL, McCullough JN, Galla JD, Griepp RB: Surgical treatment of the dilated ascending aorta: when and how?. Ann Thorac Surg. 1999, 67 (6): 1834-1839. discussion 1853-6
  14. Polvani G, Barili F, Dainese L, Topkara VK, Cheema FH, Penza E, Ferrarese S, Parolari A, Alamanni F, Biglioli P: Reduction ascending aortoplasty: midterm follow-up and predictors of redilatation. Ann Thorac Surg. 2006, 82 (2): 586-591
  15. Kamada T, Imanaka K, Ohuchi H, Asano H, Tanabe H, Kato M, Ogiwara M, Yamabi H, Yokote Y, Kyo S: Mid-term results of aortoplasty for dilated ascending aorta associated with aortic valve disease. Ann ThoracCardiovasc Surg. 2003, 9: 253-256