We
parallelly planned for Bentall procedure on high-risk basis with ongoing
resuscitation and stabilization. Our approach was via median sternotomy.
The aortic root and ascending aorta were aneurysmal (Figure 1). Right
atrial appendage was firm on palpation. Standard aorto-bicaval
cannulation was done. Cardiopulmonary bypass was established. Aortic
valve with ascending aorta was replaced with aortic valved conduit with
re-implantation of coronary buttons. A large, organized clot occupying
right atrial appendage (Figure 2) was removed.
Immediate post-operative period was uneventful other than deranged liver
function tests which were in improving trend. The patient was discharged
on post-operative day ten.