https://doi.org/10.4081/monaldi.2024.2936

Asymptomatic giant ascending aortic aneurysm: a challenging surgical strategy for a silent bicuspid aortopathy

Early Access
Submitted: January 29, 2024
Accepted: March 12, 2024
Published: March 18, 2024
Ascending aorta, giant aneurysm, bicuspid aortopathy, modified-Cabrol technique, cardiac-surgery
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PDF_EARLY VIEW: 158
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Authors

Maria Grazia Romeo
mariagrazia2791@gmail.com
https://orcid.org/0000-0002-4973-4078
Department of Advanced Biomedical Sciences, Cardiac Surgery, University “Federico II”, Naples, Italy.
Emanuele Pilato
https://orcid.org/0000-0003-0989-7048
Department of Advanced Biomedical Sciences, Cardiac Surgery, University “Federico II”, Naples, Italy.
Raffaele Giordano
https://orcid.org/0000-0002-8046-810X
Department of Advanced Biomedical Sciences, Cardiac Surgery, University “Federico II”, Naples, Italy.
Giuseppe Comentale
https://orcid.org/0000-0003-3176-5391
Department of Advanced Biomedical Sciences, Cardiac Surgery, University “Federico II”, Naples, Italy.
Gabriele Iannelli
Department of Advanced Biomedical Sciences, Cardiac Surgery, University “Federico II”, Naples, Italy.
Domenico Romeo
https://orcid.org/0009-0007-3766-6040
Department of Biomedical Sciences and Morphologic and Functional Imaging, University of Messina, Italy.
Bruna Miserrafiti
Division of Cardiology, Tiberio Evoli Hospital, Melito Porto Salvo, Italy.
Luigi Di Tommaso
Department of Advanced Biomedical Sciences, Cardiac Surgery, University “Federico II”, Naples, Italy.

We report the case of an incidental finding of a huge aneurysm of the ascending aorta with a congenital bicuspid aortic valve type 0-lateral. This severe condition was totally unknown to the patient, who was asymptomatic for cardiovascular disease. The aneurysmal mass involved the entire mediastinum, altering the normal anatomical relations, so the operative strategy was modified intraoperatively, tailoring the surgical technique to the anatomical conditions found. Despite a delayed awakening, the patient had an uncomplicated postoperative course. Therefore, this case highlights the importance of not underestimating nonspecific, seemingly harmless symptoms and signs that may reveal potentially catastrophic pathologies, while also focusing on the surgical technique used. The modified Cabrol procedure, while an underutilized technique, if present in the cardiac surgeon's "arsenal," can represent a life-saving strategy in complex cases requiring an aortic valve and ascending aorta replacement.

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How to Cite

Romeo, Maria Grazia, Emanuele Pilato, Raffaele Giordano, Giuseppe Comentale, Gabriele Iannelli, Domenico Romeo, Bruna Miserrafiti, and Luigi Di Tommaso. 2024. “Asymptomatic Giant Ascending Aortic Aneurysm: A Challenging Surgical Strategy for a Silent Bicuspid Aortopathy”. Monaldi Archives for Chest Disease, March. https://doi.org/10.4081/monaldi.2024.2936.
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