Aortic valve replacement in the patient with extensive calcification of the ascending aorta (the porcelain aorta).

The best management for patients requiring cardiac procedures with superimposed severe intimal atheromatous disease or medial calcification of the ascending aorta and transverse arch has yet to be established. Clamping such an aorta can produce embolization, dissection, mural laceration, and hemorrhage. Successful surgical treatment of two patients with a porcelain aorta requiring aortic valve replacement is reported. Traditional aortic cross-clamping was avoided with femoral artery cannulation, profound hypothermia, and circulatory arrest.