Rare Case: Modified Bentall Procedure

Modified Bentall Procedure
(Calcified Ascending Aorta)

A 30 year old man having severe aortic regurgitation with
 ascending aortic aneurysm stopping short of arch vessels 
along with mildly dilated and calcified descending thoracic
 aorta. Ascending aorta also was calcified quite heavily. 
After echocardiography, CT-Angio and Coronary Angiogram
 - Bentall procedure was planned. Per-operatively big 
chucks of calcium were found around the LAD, Circumflex
 and Right Coronary Ostia (Circumflex had it's independent 
origin). LIMA was not of good quality. 
We still thought that we'll be able to put right coronary
 button onto the graft & carried out the same but it failed
miserably and we had to do triple vessel grafting with 
SVG along with replacement of the aortic valve
and ascending aorta with valved conduit.

Patient was weaned off bypass without any problems and
recovered well to go home on the 9th post-op day. 

Dr. Ashwani Suri
suricardiac.com

UPDATE  (June 20, 2015)
Patient asymptomatic.
After due counseling and consent, in April 2015, CT angio was done which revealed good surgical outcome.