Reoperation for calcified aortic homograft: minimizing dissection Free

>A 50-year-old man, underwent aortic valve replacement 7 years previously complicated by late culture-negative prosthetic endocarditis 5 months thereafter requiring reoperation with a cryopreserved homograft. He now presents with symptomatic aortic stenosis and a calcified homograft. He underwent a third-time sternotomy with implantation of a mechanical conduit and single-vessel coronary bypass. In contrast to the external dissection of the homograft, we demonstrate the alternate approach working inside the homograft to debride the calcium, which is ‘non-invasive’ essentially as an endarterectomy. With this approach, there is no need to mobilize (and potentially injure) the coronary artery buttons.