Aortic dissection one year after aortic valve replacement.

Acute aortic dissection after aortic valve replacement is rare. A 57-year-old man presented with an acute type A aortic dissection 1 year after aortic valve replacement, which originated from the previous aortotomy site. He underwent a Bentall procedure. Postoperatively, he developed complete heart block requiring permanent pacemaker implantation. During aortic valve replacement, risk factors for aortic dissection (diameter of the aorta and fragility and thinness of the aortic wall) should be assessed. Prophylactic aortic root replacement should be undertaken if the aortic root is more than 45 mm in diameter.