Valve-sparing aortic root replacement in patients after a previous operation for acute type A aortic dissection.

T he list of long-term complications after surgical intervention for acute type A aortic dissection includes recurrent dissection, aneurysm formation, and aortic valve regurgitation. Ten years after the initial operation for acute type A dissection, the reoperation rate for these kinds of long-term complications is 13% to 30% in the literature.1 The diseased aortic root in these patients is commonly treated with the replacement of the aortic valve and ascending aorta with an artificial composite graft carrying a mechanical or biologic valve substitute. Recently, we have described the feasibility of valve-sparing aortic root replacement in acute type A dissection.2 However, no reports are available on the feasibility of valve-sparing aortic root replacement after a previous operation for acute type A dissection involving the aortic root. Here we report on 3 patients who underwent reoperation after an operation for acute type A dissection involving the aortic root, ascending aorta, and aortic arch. In all 3 cases we successfully performed valve-sparing aortic root replacement.