Misplacement of left ventricular vent into the aortic root during a re-do Bentall procedure: a case report

BACKGROUND: The left ventricular (LV) vent is commonly inserted via the right superior pulmonary vein (RSPV) and directed toward the LV cavity through the mitral valve. We report a rare case in which the tip of the LV vent was misplaced into the aortic root across the aortic valve. CASE PRESENTATION: An 88-year-old man was scheduled to undergo the Bentall procedure. After initiation of cardiopulmonary bypass, the LV vent was inserted via the RSPV. Anterograde cardioplegia was administered via the aortic root cannula after the ascending aorta was cross-clamped. The electrocardiogram did not result in complete cardiac arrest, even after delivery of two-thirds of the planned dose. A transesophageal echocardiographic examination showed that the tip of the LV vent was misplaced into the aortic root across the aortic valve. CONCLUSIONS: It is important to confirm the tip position by transesophageal echocardiography to prevent severe complications associated with the LV vent. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40981-023-00608-w.