Valve-sparing root replacement after prior Starr-Edwards aortic valve replacement

Historically, patients with prior aortic valve replacements who subsequently present with an ascending aortic aneurysm require placement of a valve conduit. However, if the patient has a functional mechanical valve with proven long-term durability, an attempt can be made to preserve the intact valve and to graft the aneurysmal aortic root. The case is described of a patient with a previously placed Starr-Edwards aortic valve who subsequently developed a 6-cm ascending aortic aneurysm. By removing the valve ball and using the existing sewing ring, a proximal graft anastomosis was created with ease, eliminating valve excision.