Replacement of valve prosthesis within aortic composite graft.

A 64-year-old man was referred for aortic valve re-replacement due to moderate-to-severe stenosis that developed 10 years after complete aortic root replacement using a stentless valve composite graft. He also had coronary heart disease and a mitral valve defect with predominant insufficiency. The patient underwent re-do surgery consisting of coronary artery bypass grafting, mitral valve replacement, and replacement of the valve prosthesis within the aortic conduit, which I believe is the first report of such a procedure.