Abstract

A 77-year-old frail woman with a 5.1-cm ascending aortic aneurysm, enlarged aortic root, and severe aortic regurgitation (Figure 1, A) underwent an uneventful valve-sparing aortic root replacement (David V procedure) and ascending aorta replacement. Postoperative transthoracic echocardiogram demonstrated a competent aortic valve with a coaptation zone of 8 mm. She was discharged on postoperative day 7. One month later, the patient presented after a syncopal episode. Further workup including cardiac computed tomography angiography (CCTA) revealed an area of contrast extravasation at the proximal lesser curvature of the aortic arch.

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