Valve-sparing root replacement with short saphenous vein interposition for left coronary artery reconstruction in redo type A aortic dissection: a case report.

Redo aortic root surgery for acute type A aortic dissection is technically demanding, particularly when coronary reconstruction is complicated by tissue fragility. Reliable bailout strategies are required when direct coronary reimplantation is unsafe during valve-sparing root replacement. A 52-year-old man previously underwent total arch replacement with a frozen elephant trunk for acute type A aortic dissection. He later developed progressive aortic root dilatation and a proximal anastomotic pseudoaneurysm, and redo valve-sparing root replacement was performed. Intraoperatively, the left coronary artery was severely dissected and unsuitable for reimplantation. A short segment saphenous vein graft was interposed between the trimmed left main trunk and the neo-aortic root. Postoperative imaging confirmed preserved valve function and satisfactory coronary flow. Short-segment saphenous vein interposition represents a practical bailout option in complex redo aortic root surgery.