Valve-sparing repair after aortic root dissection following heart transplantation

We describe the case of a 56-year-old male who presented with a Stanford ty pe A dissection limited to the donor aorta 25 days after orthotopic heart t ransplantation. Transesophageal echocardiography revealed a newly developed aortic regurgitation grade III and a typical intimal tear 1 cm above the c ommissures. Surgical therapy included replacement of the ascending aorta wi th an aortic allograft and implantation of the native aortic valve inside t he allograft as a modified David procedure.