Retrograde Flow in the Descending Thoracic Aorta

A 55-year-old woman was admitted with congestive heart failure caused by severe aortic valve stenosis. Conventional aortic valve replacement could not be performed because of a porcelain aorta. Thus, via an anterolateral thoracotomy, a Hancock 20-mm prosthesis (Medtronic Inc., Minneapolis, Minn) was inserted into the apex of the left ventricle and connected to a Carbomedics Carbo-Seal 21-mm valved conduit (Sulzer Carbomedics Inc., Austin, …