title: A huge saccular aortic aneurysm compressing right coronary artery 7 years after aortic valve replacement due to bicuspid aortic valve insufficiency: A rare case report.
abstract: BACKGROUND
  In a patient underwent aortic valve replacement (AVR) due to bicuspid aortic valve (BAV) insufficiency without marked dilation of ascending aorta, the development of delayed-typed aneurysmal complication of ascending aorta has been often reported because the dilated aorta tends to grow insidiously with age.
  
  
  METHODS
  A 58-year-old man who underwent AVR with mechanical valve due to severe aortic regurgitation secondary to BAV 7 years previously presented with exertional chest discomfort for 1 year. An echocardiography showed a well-functioning mechanical aortic valve without any significant abnormal findings. Cardiac multidetector computed tomography (MDCT) revealed a huge saccular aortic root aneurysm (79.7 mm × 72.8 mm in size) compressing the proximal right coronary artery resulting in ∼90% eccentric diffuse luminal narrowing. The patient subsequently underwent open-heart surgery with resection of the ascending aortic aneurysmal sac and consecutive ascending aorta and hemi-arch replacement using a graft.
  
  
  CONCLUSIONS
  After successful AVR in the patient with BAV insufficiency and mildly dilated ascending aorta, a regular aortic imaging such as cardiac MDCT with aortography would be helpful to monitor the morphology and size of ascending aorta and related complications to guide future management.
authors.affiliation: Cardiovascular Center, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea Utah Cardiology, Layton, Utah, United States.
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Park
authors.forename: Haemin
authors.initials: H
authors.lastname: Jeong
authors.forename: Kyung-Soon
authors.initials: KS
authors.lastname: Hong
authors.forename: Christopher
authors.initials: C
authors.lastname: Kim
mesh_terms: D001014:Aortic Aneurysm / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery; D001021:Aortic Valve / Q000002:abnormalities* / Q000601:surgery; D001027:Aortography; D000082882:Bicuspid Aortic Valve Disease; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D006349:Heart Valve Diseases / Q000150:complications* / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D013997:Time Factors