A 12.8 cm Diameter: Giant Aortic Aneurysm (GAA) Successfully Treated by Bentall’s Procedure- Case Report

Abstract

Background: Aortic root aneurysm involves dilatation of sinuses of Valsalva, sinotubular junction, and proximal ascending aorta. It is a rare complication after aortic valve replacement surgery. A giant aneurysm is defined as an aneurysm of size> 10 cm. Surgical treatment involves Bentall’s procedure. Case Detail: A 40-year-old gentleman with severe aortic regurgitation and moderate aortic stenosis underwent aortic valve replacement with a mechanical prosthetic valve of size 25 mm, 13 years ago. At the time of previous surgery, the ascending aorta was mildly dilated, measured 3.5 cm in size. The patient came with complaints of breathlessness on exertion from the past two months, NYHA class III. Echocardiography and CECT revealed a giant ascending aortic aneurysm about 12.8 cm in diameter with intimal flap suggestive of dissection. Prosthetic valve function and other cardiac structures were assessed as normal. Elective surgery was planned. CPB was established. Ascending aortic aneurysm was excised along with a prosthetic mechanical valve. Bentall’s procedure was done using a 27 mm Dacron composite graft. The patient required a permanent pacemaker for a complete heart block in the postoperative period. Thereafter patient was discharged in stable condition. Conclusion: Aortic aneurysm should be tackled surgically in order to decrease morbidity and mortality. Regular follow-up of such patients should be done.