Endarterectomy of the ascending aorta: an alternative method in patients with extensively calcified (porcelain) aorta requiring aortic valve replacement.

A variety of surgical techniques have been described to manage the extensively calcified (porcelain) aortic root in patients requiring aortic valve replacement. We report two cases in which endarterectomy of the proximal ascending aorta was successfully performed. Endarterectomy of the left main coronary artery ostium was also performed in the one patient, and aortic root enlargement with patch aortoplasty in another. The technical aspects of the procedure and alternative approaches are discussed.