[Aortic dissection after aortic valve replacement for bicuspid aortic valve complicated with ascending aortic dilatation; report of a case].

Congenital bicuspid aortic valve (BAV) is known to be a predisposing factor for aortic aneurysms and dissection because of intrinsic weakness of the aortic wall. We report here a case of 58-year-old man who developed type A aortic dissection 40 months after aortic valve replacement (AVR) for a congenital BAV. The ascending aorta diameter was 48 mm at the time of AVR. Computed tomography revealed ascending aortic dilatation (maximum diameter 64 mm) complicated with aortic dissection. We performed aortic root replacement and total arch replacement successfully. He has been doing well after the operation. In patients of congenital BAV with a baseline ascending aortic diameter of >40 mm, especially in young patients, complete replacement of the ascending aorta at the time of AVR should be considered in order to prevent future aortic complications.