Redo aortic root aneurysm surgery: a Mayo Clinic case study
In this Mayo Clinic case study, experts present a highly complex redo aortic root aneurysm repair in a 48-year-old patient with extensive prior aortic surgery. Surveillance imaging revealed a 6.6 cm aortic root aneurysm with moderate aortic valve regurgitation, and conventional cross-clamping was not feasible due to altered anatomy and an existing thoracic stent graft.
The team describes an alternative operative strategy using dual arterial cannulation for independent cerebral and systemic perfusion, combined with intra-aortic balloon occlusion placed within the prior stent graft under echocardiographic guidance. This innovative approach enabled safe replacement of the aneurysmal aortic root with a mechanical valved conduit and standard coronary reimplantation, without disrupting previous arch reconstruction. The patient recovered uneventfully and was discharged on postoperative day six.
