Completion bentall procedure after aortic valve replacement

A 51-year-old man, who had undergone aortic valve replacement with a mechanical valve 30 years ago, was referred to our hospital due to acute type A aortic dissection. Pre- and intra-operative echocardiographic evaluation showed no evidence of valve dysfunction or paravalvular leak. Intraoperative inspection revealed a thin pannus covering the leaflet housing of the mechanical valve, which we easily removed. We performed aortic root replacement while leaving the valve in situ, and total aortic arch replacement using elephant trunk technique under hypothermic circulatory arrest. He was discharged from the hospital 31 days after operation and retains normal valve function. For patients with aneurysms and acute type A aortic dissection having aortic valve prosthesis that does not require replacement, the completion Bentall procedure is a more secure and safer repair than complete aortic root reconstruction.