This patient had a severely calcified valve which then became infected with endocarditis with abscess cavities under the left main coronary artery and right coronary artery.
To begin the procedure, the patient was placed on bypass and retrograde cardioplegia was given. The aorta was resected, and two large abscess cavities were found disrupting the aortoventricular continuity. The coronary buttons were mobilized and horizontal mattress pledgeted sutures were used to close the abscess cavity and suture in the homograft. A Duran annuloplasty ring was used to prevent late aortic root dilatation and the buttons. Finally, distal anastomosis was performed.
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