Successful Aortic Root Replacement with Aortic Arch Aneurysm Repair: A Case Report

Abstract

We report a successful first stage repair in a patient with extensive aortic aneurysm. A 61 year-old woman with hypertension for 4 years came to the hospital with problems of congestive heart failure. Physical examination and investigations revealed severe aortic regurgitation with compromised cardiac function (45% of ejection fraction) and a long segment of aortic aneurysm from the aortic annulus to the level of renal arteries. At surgery, aortic root replacement was performed first, then the lower body circulation was temporarily stopped and modified elephant trunk operation was done. The heart was then allowed to beat while re-warming process was being done. The last step was to reconnect the two head vessels to the graft with bifurcated Dacron graft. Two hours postoperatively, the patient gained consciousness with good motor responses and remained in ICU for 3 days and was discharged home on day 9 with antihypertensive agents and warfarin. She was planned for completion of the treatment within 4 months postoperatively.