Type A Aortic Dissection After the Ross Procedure.

We describe a case of type A aortic dissection in a 25-year-old woman who had undergone a Ross procedure for aortic valve endocarditis 13 years previously. She was pregnant and noted to have significant enlargement of the aortic root during the latter portion of the third trimester of her pregnancy. An echocardiogram after delivery demonstrated new aortic valve insufficiency in addition to an aortic root diameter of 6.5 cm. A computed tomography angiogram demonstrated a type A aortic dissection involving only the very proximal portion of the ascending aorta. At operation, the dissection was found to be limited to the pulmonary autograft. This was repaired using a valve-sparing technique. Her postoperative course was uneventful, and the aortic valve has shown only trace insufficiency at 3 years of follow-up.