Sabzi Feridoun, Heydari Aghigh, Azimivaghar Javad, Asadmobini Atefeh
Cardiovascular Research Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
J Med Case Rep. 2025 Jul 3;19(1):308. doi: 10.1186/s13256-025-05367-z.
The Bentall procedure is the standard treatment for aortic root aneurysm associated with aortic valve disease, but it carries risks of both early perioperative complications and long-term prosthetic-valve-related issues. To overcome these limitations, we applied a novel surgical technique combining Dacron graft wrapping of the aortic root with autologous pericardial valve reconstruction.
We report a 59-year-old Iranian male with a history of aortic root aneurysm, recurrent peptic ulcers, and intolerance to warfarin. He presented to the emergency department following a car accident, complaining of severe chest pain and displaying anterior chest wall bruising. Transthoracic echocardiography revealed a small intramural hematoma and aneurysmal dilation of the ascending aorta. Emergency surgery was performed using the described novel approach due to suspicion of an intramural aortic aneurysm. The patient's postoperative course was uneventful, and at 6-month follow-up, he remained clinically stable with only minimal residual aortic regurgitation.
This case highlights the potential of combining Dacron root wrapping with autologous pericardial valve reconstruction as a viable alternative to conventional prosthetic valve replacement, especially in patients with contraindications to long-term anticoagulation.
Bentall手术是治疗与主动脉瓣疾病相关的主动脉根部瘤的标准方法，但它存在围手术期早期并发症和长期人工瓣膜相关问题的风险。为克服这些局限性，我们应用了一种将涤纶补片包裹主动脉根部与自体心包瓣膜重建相结合的新型手术技术。
我们报告一名59岁的伊朗男性，有主动脉根部瘤、复发性消化性溃疡病史，且对华法林不耐受。他在车祸后被送往急诊科，主诉严重胸痛并伴有前胸壁瘀伤。经胸超声心动图显示升主动脉有小的壁内血肿和动脉瘤样扩张。由于怀疑有壁内主动脉瘤，采用所述的新型方法进行了急诊手术。患者术后恢复顺利，在6个月的随访中，他临床稳定，仅存在轻微的残余主动脉瓣反流。
本病例突出了涤纶补片包裹根部与自体心包瓣膜重建相结合作为传统人工瓣膜置换可行替代方案的潜力，特别是在有长期抗凝禁忌证的患者中。
