Implantation of a sutureless aortic valve into the ring of a mechanical valve: an extreme solution for extreme cases

Reoperations due to dysfunction of artificial mechanical aortic valves represent a complex and high-risk surgical procedure, particularly for elderly patients. In this report, we present a case of an 81-year-old female patient where, due to structural degeneration of the mechanical valve, an emergency surgical procedure was indicated. After the removal of the valve leaflets, a sutureless aortic valve was implanted within the mechanical ring. In our case, we demonstrate that such an approach is a safe alternative for high-risk patients, who cannot undergo percutaneous procedures. By reducing the duration of cardiopulmonary bypass and aortic clamping, the surgical outcomes and complication rates can be significantly improved.