Management of ascending aortic aneurysm and valvular incompetence with external remodeling

Aneurysmatic dilatation of the sinotubular junction may result in aortic valvular incompetence even if the leaflets remain structurally intact. Traditionally, such situations are managed by open techniques of both the ascending aorta and the aortic valve. We present a case of aortic regurgitation, due to a 50-mm diameter ascending aortic aneurysm, which was corrected by sinotubular remodeling and wallreinforcement without the usage of cardio-pulmonary bypass. The authors describe a calculation-based and a transesophageal echo controlled technique of external reconstruction of the aorta and correction of the aortic regurgitation.