Modified Reimplantation of Tricuspid Aortic Valve in a Patient With Type I DeBakey Acute Aortic Dissection
Optimal treatment of the acute type A dissection is still controversial. The current guidelines give indistinct recommendations about which surgical valve-sparing procedure should be performed when aortic dissection occurs and which method of cannulation should be used for appropriate antegrade perfusion. Cannulation of the innominate artery has been a perfect alternative for 20 years, including in patients with acute type A aortic dissection (1). However, the published data contain fewer reports about this approach than about axillary or femoral cannulation. Compared with axillary or femoral artery cannulation, innominate artery cannulation has several advantages: absence of the need for a second incision, higher flow rate, and antegrade cerebral perfusion (2, 3). Today, aortic valve reimplantation technique is performed relatively rarely (<10%) in patients with acute type A aortic dissection (4). This type of surgery requires higher surgical skills and is used with caution in this category of patients. Here, the authors present innominate artery cannulation and modified reimplantation of tricuspid aortic valve in a young man with type I DeBakey acute aortic dissection (5, 6). Postoperative echocardiography one year later after surgery showed a satisfactory result of the procedure with good aortic valve function. Coaptation zone of the reimplanted valve was type A according to Pethig classification (7).
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