Prosthetic Valve Endocarditis After Y-Incision Aortic Annular Enlargement: A Simple Solution.

The Y-incision aortic annular enlargement (AAE) has been established as a safe and effective technique for upsizing the aortic annulus by 3 to 4 valve sizes. However, concerns have been raised regarding its technical complexity during reoperations, particularly given the extensive enlargement of the aortic annulus and root. We present a case of reoperative aortic valve replacement after previous Y-incision AAE for prosthetic valve endocarditis and aortic root abscess. Our case highlights the simplicity and effectiveness of using a rectangular patch for root reconstruction and implanting the "roof" technique for aortotomy closure in reoperations after Y-incision AAE.