Successful surgical management of a dissecting aneurysm of the ascending and transverse aorta with heart failure due to sudden, severe aortic valve insufficiency.

A dissecting aneurysm of the ascending and transverse aorta with heart failure due to sudden severe arotic valve insufficiency in a 47-year-old man has been treated successfully. Vasodilator therapy was done preoperatively, and then hemodynamics was improved markedly. A selective perfusion technique by using separate pumps at pre-determined flow-rates with hypothermia was utilized. The replacement of both the aortic valve and the ascending and transverse aorta involving brachiocephalic artery with a prosthetic valve and expanded polytetra-fluoroethylene coated woven Dacron grafts was performed.