Ascending aorta dissection following aortic valve replacement (AVR), is a rare but potentially fatal complication. The optimal surgical management of patients with aortic valve disease associated with ascending aortic dilatation is a controversial issue. While replacement of ascending aorta at the time of prosthetic valve implantation is mandatory when marked dilatation of the aortic root is present, the surgical strategy in case of moderate dilatation is still unclear. In patients with ascending aortic dilatation, AVR alone may not prevent progression of aortic root enlargement. Painless ascending aorta dissection and significant further enlargement of ascending aorta in eight months after aortic valve replacement have been observed in a patient who showed mild to moderate ascending aortic dilatation at the time of the aortic valve replacement.
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