The Largest Reported Dissecting Aneurysm of Ascending Aorta Following Aortic Valve Replacement Accompanied by Superior Vena Cava Syndrome

Abstract

BACKGROUND: Ascending aortic dissection (AAD) is a rare and serious complication of aortic valve replacement. Multiple risk factors such as connective tissue disease, aortic wall thinning, aortic diameter, calcification of wall, structural features of aortic wall and associated diseases have been considered as a predisposing factor for the occurrences of AAD. Preoperative recognition of these variables with proper intra intra operative logic judgment may decrease tehe incidence of this complication.
CASE DETAILS: We herein present a huge ascending aorta with dissecting aneurysm (AAD) with a largeintra-operative diameter (15cm) that has not been recorded in the medical literature so far. He presented with dyspnea, chest pain and amazing symptom of superior vena cava syndrome. The patient underwent open heart surgery with resection of ascending aorta aneurysm with classic Bentall operation. The post-operative period was associated with uneventful course and the patient was discharged with good condition on 12th post-operative day.
CONCLUSION: A six months’ follow-up revealed abolishment of chest pain and superior vena cava (SVC) syndrome and good prosthetic composite graft function with no recurrence of pseudo aneurysm or dissection.

KEYWORDS: aneurysm, ascending aorta, superior vena cava syndrome