Valve-sparing repair after aortic root dissection following heart transplantation.

We describe the case of a 56-year-old male who presented with a Stanford type A dissection limited to the donor aorta 25 days after orthotopic heart transplantation. Transesophageal echocardiography revealed a newly developed aortic regurgitation grade III and a typical intimal tear 1 cm above the commissures. Surgical therapy included replacement of the ascending aorta with an aortic allograft and implantation of the native aortic valve inside the allograft as a modified David procedure.