Ascending aorta replacement and repair of aortic valve because of ascending aorta aneurysm and bicuspid aortic valve with regurgitation

The case report describes the hospitalization of a patient with an ascending aortic aneurysm and a bicuspidal aortic valve. Valvular surgery with an annular annuloplasty ring implant was performed. At the same time, replacement of the ascending aorta was performed. There were no more serious complications in the postoperative period and the patient was released to outpatient care on the eighth postoperative day.

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47-year-old man
PA: no diseases in history, controlled because of ascending aorta aneurysm during last nine years
FA: no hereditary diseases in family history
PA: no drug using
AA: no allergies
DA: no drug using
SA: no important data
AD: Patient with bicuspid aortic valve, combined diseases of aortic valve (AVA 1.7 cm2) and ascending aorta aneurysm (CT and TEE 5,3-5,4 cm). Imaging investigation method showed progression of diameter of ascending aorta during last three years. Patient do not present any symptoms. No dyspnoea, no angina pectoris, no collapse, no palpitation and no oedema of lower limbs. Surgery of the ascending aorta aneurysm is indicated because of diameter progression.

Laboratoty results:

Laboratory values: physiological

Imaging methods:

Echocardiography: aortic valve cusps – BAV, Ao bulbus 4.1cm, STJ 3.9cm, ascending aorta 5.3cm, LV is not dilated, good LVEF, speed of blood in location of aortic valve 2.5m/s, calculated AVA 1.7cm2, arch of the aorta is not dilated

Coronarography: left common coronary artery: no stenosis; LAD: no stenosis; RCX: no stenosis; right coronary artery: no stenosis.

CT angiography: Ascending aorta aneurism – 54x54mm; diameter of the arch of aorta: 32mm (in place of truncus brachiocephalicus), 23mm (in place of left subclavian artery); diameter of descending aorta: 25mm.


Ascending aorta aneurysm (TEE 5,3 cm/CT 5,4 cm)
Combined disease of bicuspid aortic valve
High blood pressure 1. degree ESH/ESC (new diagnosis)

Therapy and conclusion:

Treatment strategy:
Repair of aortic valve and replacement of ascending aorta is indicated.

Surgery procedure:
Annulo et valvuloplastica aortalis cum ring apertum No. 27, Substitutio aortae ascendentis cum tubular graft No. 28 – CPB: 112min, aortic clamping time: 96min.

Postoperative course:
No important postoperative complication was recorded. On the 8th postoperative day released to outpatient care.


Abbreviation: Ao – aorta/aortic; AVA – aortic valve area; BAV – bicuspid aortic valve; CPB – cardiopulmonary bypass; CT – computer tomography; ECHO – echocardiography; LAD – left anterior descending artery; LV – left ventricle; LVEF – left ventricle ejection fraction; RCX – circumflex artery; STJ – sino-tubular junction; TEE- transoesophageal echocardiography

Authors declare the case report will not be published in any national or international publications.

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