[A case report of the dissecting aneurysm of ascending aorta, which was surmised to be developed after aortic valve replacement].

Bentall operation was performed for the ascending aortic dissection in the patient of a 70-year old man, who had undergone aortic valve replacement (AVR) for aortic valve regurgitation 7 years ago. At the AVR, the diameter of the ascending aorta was 50 mm on CT. During the follow up period after AVR, the ascending aorta was gradually developed to 95 mm in diameter without any symptoms. During the reoperation, entry was recognized on the prior aortotomy reinforced with felt-strips and the intimal flap was thickened. These situations suggested that the aortic dissection might be occurred just or early after AVR, and the reinforcement of aortotomy using felt-strips and AVR could not prevent progression of aortic root enlargement and dissection. From some previous reports about ascending aortic dissection after AVR, an adequate surgical treatment for a dilated ascending aorta (40-50 min) should be required at the same time of AVR.