title: Chronic dissecting aneurysm of the ascending aorta developed in a patient who had rejected surgical treatment for type II acute ascending aortic dissection three years earlier.
abstract: A 66-year-old male patient was admitted to our clinic because of shortness of breath and chest pain. A grade 4/6 diastolic murmur was heard on auscultation. Physical examination revealed signs of congestive heart failure and poor peripheral perfusion. There was a diagnosis of type II ascending aortic dissection in the history of the patient. He had refused emergency surgical intervention three years earlier. Computed tomography revealed that the ascending aorta was dilated to about 10 cm in diameter, and there was a chronic aortic type II dissection. The patient had second- to third-degree aortic insufficiency and he had a calcified bicuspid aortic valve on echocardiography. Two-vessel disease and a 90-mmHg aortic gradient were detected on angiography. Graft replacement of the ascending aorta, serape aortic valve replacement with a mechanical valve, and coronary arterial bypass grafting were performed successfully under cardiopulmonary bypass with an open aortic technique. The patient was discharged on the 10th postoperative day with no problems.
authors.affiliation: Department of Cardiovascular Surgery, Erzurum Regional Training and Research Hospital, Erzurum, Turkey. bilgehanerkut9@hotmail.com.
authors.forename: Bilgehan
authors.initials: B
authors.lastname: Erkut
authors.affiliation: Department of Cardiovascular Surgery, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Dag
authors.affiliation: Department of Cardiovascular Surgery, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Kaygïn
authors.affiliation: Department of Cardiovascular Surgery, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
authors.forename: Husnu Kamïl
authors.initials: HK
authors.lastname: Lïmandal
authors.affiliation: Department of Cardiovascular Surgery, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Aydïn
authors.affiliation: Department of Cardiovascular Surgery, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
authors.forename: Eyup Serhat
authors.initials: ES
authors.lastname: Calïk
mesh_terms: D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000601:surgery*; D001011:Aorta / Q000601:surgery*; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000601:surgery*; D001021:Aortic Valve / Q000002:abnormalities* / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000601:surgery; D000082882:Bicuspid Aortic Valve Disease; D002315:Cardiopulmonary Bypass / Q000379:methods; D002908:Chronic Disease; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome