Background: Extensive calcification of the ascending aorta that is recently termed as “porcelain aorta” is
quite an unusual finding in younger population. Advanced or severe atherosclerosis is the main reason for the calcification of the aorta, especially when people get older. Chlamydia pneumoniae infection has been shown in several studies as related with early atheromatous plaque formation. Though the etiology remains obscure in many patients in younger age the
pathology requires a special attention for surgical approach.
Case Report: We present 14 year-old girl with mitral valve disease and severe ascending aortic calcification that was operated succesfully by femoral cannulation and hypothermic low flow circulation with retrograde cold crystalloid cardioplegia via coronary sinus. Mitral valve replacement was performed.
Conclusion: There was no case reported in the literature who underwent the mitral valve replacement
procedure with highly severe aortic calcification in this young age.

Keywords: porcelain aorta, mitral valve surgery, atherosclerosis