Upward Displacement of Prosthetic Aortic Valved Conduit after Modified Bentall Procedure for Type A Acute Aortic Dissection

Aim: Role of non-invasive coronary artery computed tomography (CACT) in diagnosis of complications of aortic root surgery in patients with chest pain.
Introduction: Dehiscence of an aortic valved conduit or pseudoaneurysm development is a rare, but serious and potentially life-threatening complication after aortic root surgery.
Case Presentation: We report an interesting case of a 61-year-old man with chest pain and dyspnea, previous history of modified Bentall procedure for type A acute aortic dissection and coronary stenting, that shows a complete detachment and upward displacement of a composite tubular graft with mechanical valve prosthesis detected by a CACT angiography.
Discussion: Generally, in the few survivors, the diagnosis is made by means of echocardiography. This is the first case of CACT diagnosis of a prosthetic aortic valved conduit displacement after a modified Bentall procedure for type A acute aortic dissection. With the use of this imaging technique was possible a complete evaluation of the coronary stents and the native coronary arteries, avoiding the coronary artery angiography that adds an elevation of the risk for this kind of patients.
Conclusion: In symptomatic patients with a previous history of treated aortic dissection and coronary artery disease without evidence of recurrent ischemia, the CACT angiography can be considered a good diagnostic option. It provides detailed informations about the coronary arteries and the aorta allowing an accurate diagnosis.