DOI: https://doi.org/10.36347/sasjs.2025.v11i12.011

Pages: 1122-1125

Background: Acute aortic dissection involving the entire aorta is a life-threatening condition, particularly in patients with Marfanoid features and severe aortic insufficiency. Surgical intervention remains challenging, especially in high-risk individuals with significant comorbidities. Case: We report the case of a 58-year-old male with Marfanoid features, a history of spontaneous pneumothorax, and chronic smoking (45 pack-years), who presented with acute aortic dissection extending from the ascending aorta to the aortoiliac bifurcation. Preoperative transthoracic echocardiography (TTE) revealed severe aortic insufficiency. The patient underwent successful aortic root replacement using the Tirone David procedure. Postoperative imaging (TTE and CT scans) confirmed a well-positioned aortic root graft, with no evidence of stenosis or regurgitation. Conclusion: This case demonstrates the efficacy of the Tirone David procedure in managing extensive aortic dissection with aortic insufficiency in high-risk patients, offering durable outcomes and valve preservation.