A 12.8 CM DIAMETER: GIANT AORTIC ANEURYSM (GAA) SUCCESSFULLY TREATED BY
BENTALL’S PROCEDURE- Case Report
Background: Aortic root aneurysm involves dilatation of sinuses of
Valsalva, sinotubular junction and proximal ascending aorta. It is a
rare complication after aortic valve replacement surgery. Giant aneurysm
is defined as aneurysm of size> 10 cm. Surgical treatment
involves Bentall’s procedure. Case Detail: A 40 year old gentleman with
severe aortic regurgitation and moderate aortic stenosis underwent
aortic valve replacement with a mechanical prosthetic valve of size 25
mm, 13 years ago. At the time of this surgery the ascending aorta was
mildly dilated, measured 3.5 cm in size. Patient came with complaints of
breathlessness on exertion from past two months, NYHA class III.
Echocardiography and CECT revealed giant ascending aortic aneurysm about
12.8 cm in diameter with intimal flap suggestive of dissection.
Prosthetic valve function and other cardiac structures were assessed as
normal. Elective surgery was planned. CPB established via right axillary
artery and right femoral vein. Ascending aortic aneurysm was excised
along with prosthetic mechanical valve. Bentall’s procedure was done
using 27 mm Dacron composite graft. Patient required permanent pacemaker
for complete heart block in post operative period. Thereafter patient
was discharged in stable condition. Conclusion: Aortic aneurysm should
be tackled surgically in order to decrease the morbidity and mortality.
Regular follow up of such patients should be done.