[A successful surgical case report of acute aortic dissection involving entire sinus of Valsalva].

We successfully performed aortic root replacement for acute aortic dissection, Stanford type A involving the entire sinus of Valsalva, associated with acute anterior wall myocardial infarction and aortic valve insufficiency. A 57-year-old man was admitted complaining of chest pain. An emergency operation was performed after a perfusion catheter was inserted to 99% stenotic lesion of the left anterior descending artery (LAD) on the same day. The dissection extended to both ostia of the coronary arteries and disrupted all commissures of the aortic valve, resulting in severe prolapse of the aortic valve leaflets. Aortic root replacement was performed using a valved conduit. The left main coronary artery was reattached to the graft using interposition technique with a 8 mm diameter woven Dacron tube graft. In addition, the LAD and right coronary artery were bypassed using saphenous vein. The postoperative course was uneventful and the patient was discharged from hospital on the 35th postoperative day. Retaining no aortic sinus and adequate coronary artery reconstruction is important for surgical repair of aortic dissection involving the entire sinus portion of the ascending aorta.