Successful Treatment of Annulo-aortic Ectasia Associated with DeBakey's Type IIIb Dissecting Aortic Aneurysm.

Abstract

A 52-year-old man with annulo-aortic ectasia and DeBakey's type IIIb dissecting aortic aneurysm was successfully treated. Aortography showed moderate to severe aortic regurgitation and enlargement of the ascending aorta, and CT showed a huge type IIIb dissecting aortic aneurysm. We scheduled a two-staged operation because dissection occurred 6 months previously and ECG showed severe LVH and ST-T change. The aortic root replacement using Bentall's procedure was performed, which was followed by arch replacement with an elephant trunk prosthesis on distal aorta. The entry in the distal aortic arch was covered by an elephant trunk prosthesis and postoperative diagnostic images showed thrombo-occlusion of the false lumen in the descending aorta. This operation was safe and might be a useful method for annulo-aortic ectasia with type IIIb dissecting aortic aneurysm.