Case 82
Giant aneurysm of the aortic root
What would you do here? Answer
This patient ahs a giant aneurysm of the aortic root and ascending aorta. CT scanning will help to delineate whether or not the arch is involved or not. As can be seen there is minimal aortic regurgitation. This patient was asymptomatic and was referred because of an an abnormal CXR. The patient had had no angina, and cannulation of the coronary ostia was not possible.
This patient needs an aortic root replacement, and ascending aorta up to the end of the aneurysm, be it before the arch, the proximal arch of the entire arch. If the descending aorta is involved then the elephant trunk or the frozen elephant trunk procedure should be considered.