Staged Repair of Concomitant Aortic Regurgitation and Descending Thoracic Aortic Aneurysm

Descending thoracic aortic (DTA) aneurysms causing left main bronchus compression can be surgically repaired under left heart bypass (LHB). Safe LHB requires a competent aortic valve. Some patients present with concomitant DTA aneurysms and severe aortic regurgitation (AR), precluding LHB as an adjunct for aortic surgery. The authors present such a case and outline the management. AR can safely be addressed first in an immediate staged surgical approach, providing adequate left ventricular function.