**Abbreviations for figures**

A-AO ascending aorta AML anterior mitral leaflet AV aortic valve LA left atrium LAD left anterior descending artery LCA left coronary artery LCC left coronary cusp LCS left coronary sinus LMT left main truncus LVOT left ventricular outflow tract MV mitral valve NCC noncoronary cusp PA pulmonary artery RA right atrium RCA right coronary artery RCC right coronary cusp RCS right coronary sinus

R-PA right pulmonary artery

RV right ventricle

mechanism is systolic anterior motion of the mitral leaflet, which is caused by reduced left ventricular dimensions and/or a sigmoid septum due to left ventricular hypertrophy. When several measures are not effective, emergent mitral valve replacement should be considered.

Following aortic declamping, the aorta distal to the clamp site should be checked for new dissection. It may potentially develop due to detachment of the calcified aortic wall, and inner or outer layer. Dissection can also originate from the arterial cannulation site, root cannula site

In conclusion, it is essential to watch for pitfalls in aortic valve replacement for calcified aortic valve, because it is commonly associated with various pathologies that can affect the surgical outcomes. Meticulous monitoring and intraoperative diagnostic imaging are helpful for

achieving the best possible results in cases with increased risk factors.

**5.4. Aortic dissection**

514 Calcific Aortic Valve Disease

or aortotomy site.

**Abbreviations for figures**

LAD left anterior descending artery

LVOT left ventricular outflow tract

A-AO ascending aorta

AV aortic valve LA left atrium

MV mitral valve

RA right atrium

NCC noncoronary cusp

RCA right coronary artery RCC right coronary cusp RCS right coronary sinus

PA pulmonary artery

AML anterior mitral leaflet

LCA left coronary artery LCC left coronary cusp LCS left coronary sinus LMT left main truncus

STJ sinotubular junction

SVC superior vena cava
