A totally calcified ascending aorta prevents aortic crossclamping and aortotomy during aortic valve replacement, and replacement of the ascending aorta is a valid option in these cases. We describe a simple technique for calcified ascending aorta replacement using the Cavitron Ultrasonic Surgical Aspirator. This can be used in aortic endarterectomy for removal of the calcified plaque in the anastomotic part.
TakamiYTajimaKTerazawaSOkadaNFujiiKSakaiY. Safer aortic crossclamping during short-term moderate hypothermic circulatory arrest for cardiac surgery in patients with a bad ascending aorta. J Thorac Cardiovasc Surg2009; 130: 875–880.
2.
Isoda S, Osako M, Kimura T, et al. A stepwise aortic clamp procedure to treat porcelain aorta associated with aortic valve stenosis and hemodialysis. Ann Thorac Cardiovasc Surg 2013. Epub ahead of print 4 June. DOI: 10.5761/atcs.cr.13-00018.
3.
LiddicoatJRDotyJRStuartRS. Management of the atherosclerotic ascending aorta with endoaortic occlusion. Ann Thorac Surg1998; 65: 1133–1135.
4.
ShinHMoriMSuzukiRKudoMYozuR. Apicoaortic valved conduit with an apical connector for aortic stenosis with a calcified aorta. Gen Thorac Cardiovasc Surg2009; 57: 467–471.
5.
BuzSPasicMUnbehaunA. Trans-apical aortic valve implantation in patients with severe calcification of the ascending aorta. Eur J Cardiothorac Surg2011; 40: 463–468.
6.
BapatVNAttiaRQThomasM. Distribution of calcium in the ascending aorta in patients undergoing transcatheter aortic valve implantation and its relevance to the transaortic approach. JACC Cardiovasc Interv2012; 5: 470–476.
7.
ZahnRSchieleRGerckensU. Transcatheter aortic valve implantation in patients with “porcelain” aorta (from a Multicenter Real World Registry). Am J Cardiol2013; 111: 602–608.
8.
PascualIAvanzasPMunoz-GarciaAJ. Percutaneous implantation of the CoreValve® self-expanding valve prosthesis in patients with severe aortic stenosis and porcelain aorta: medium-term follow-up. Rev Esp Cardiol (Engl Ed)2013; 66: 775–781.