Late Aortic Dissection Following Bentall Procedure in an Inoperable Patient: A Case Report and Clinical Insights

Introduction: Pathologies of the ascending aorta, such as aneurysms and dissections, present a challenge in cardiovascular surgery. The Bentall procedure, which replaces the aorta and aortic valve while reimplanting the coronary arteries, reduces mortality and morbidity. However, the use of biological prostheses can lead to complications, such as late aortic dissections.

Case Presentation: We report the case of a patient who underwent Bentall surgery with a biological prosthesis. Several years after the procedure, he developed a late aortic dissection associated with severe chest pain. Upon examination, his blood pressure was asymmetric between the upper limbs and a soft systolic murmur was heard at the aortic area with diminished femoral pulses. The CT angiography revealed a dissection in the ascending aorta, near the graft anastomosis. Due to the advanced age and comorbidities, surgery was deemed too risky. Palliative treatment was initiated, and the patient passed away after 72 hours.

Conclusion: Patients who have undergone Bentall surgery must be monitored long-term for complications such as aortic dissections. Rigorous clinical follow-up and advanced imaging techniques are essential to improve prognosis and manage risks.