Pseudoaneurysm Formation after Aortic Root Replacement Using Freestyle Porcine Bioprosthesis

: We report a case of pseudoaneurysm formation after implantation of Medtronic Freestyle stentless bioprosthesis with a full root technique. A 65-year-old man previously underwent aortic root replacement with a Freestyle bioprosthesis. Ten years after the initial operation, pseudoaneurysm of the aortic root with a diameter of 6 cm was observed by computed tomography. At the reoperation, there was no sign of infective endocarditis, and the pseudoaneurysm was found to originate from the ruptured left and noncoronary sinuses. The aortic root was successfully reconstructed with a composite graft bearing a stented bioprosthesis. Although Freestyle bioprosthesis has several advantages over conventional stented valves, close observation should be mandatory to prevent this potentially catastrophic complication.