Bentall Surgery in a Patient after Aortic Valve Replacement Due to Takayasu Arteritis

A 57?years old woman underwent an aortic valve replacement (ATS 23?mm mechanical valve, Medtronic ATS Medical, Minneapolis, USA) for the treatment of aortic regurgitation. She was diagnosed with Takayasu arteritis post?operative pathology and prescribed 5 mg prednisolone per day after surgery. At 61 years of age, she required implantation of a ventricular pacemaker device for the treatment of an atrio ventricular block. At 64 years of age, she started experiencing dyspnea on effort. Echocardiography and contrast radiography revealed severe aortic regurgitation due to a flailed mechanical valve (Figure 1) with aortic root ectasia (annulus, 30 mm; Valsalva sinus, 62 mm; and ascending aorta, 43 mm). She underwent Bentall surgery via reopening of the mid? sternotomy.