Concomitant graft replacement of the total aortic root and the transverse aortic arch for type A aortic dissection associated with Marfan syndrome: report of a case

• Published in: Kyobu geka. The Japanese journal of thoracic surgery Vol. 47; no. 11; p. 906
• Main Authors: Saito, T, Fuse, K, Kato, M, Kamisawa, O, Kano, M, Hata, M, Oki, S, Hasegawa, N, Kawashima, T, Horimi, H
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.10.1994
• Subjects: Adult; Aneurysm, Dissecting - complications; Aneurysm, Dissecting - surgery; Aorta, Thoracic - surgery; Aortic Aneurysm, Thoracic - complications; Aortic Aneurysm, Thoracic - surgery; Blood Vessel Prosthesis; Chronic Disease; Extracorporeal Circulation; Heart Arrest, Induced; Humans; Male; Marfan Syndrome - complications
• ISSN: 0021-5252

A 25-year-old man of Marfan syndrome with chronic stage aortic dissection of Stanford type A underwent concomitant graft replacement of the total aortic root and transverse aortic arch. The surgical procedure were performed with an aid of extracorporeal circulation, blood cardioplegia, using the techniques of "open distal anastomosis" under the deep hypothermic circulatory arrest and continuous retrograde cerebral perfusion for cerebral protection during circulatory arrest. The operative techniques consisted of total aortic root replacement using a composite graft with Piehler's and Carrel patch technique for left and right coronary artery, and total arch replacement using en bloc distal arch reconstruction and a composite graft replacement for innominate artery. There were no neurological complications. In the case of Marfan syndrome, type A aortic dissection involving aortic arch should be treated by concomitant graft replacement of the total aortic root and the transverse aortic arch in order to reduce the late risk of aortic dissection or annular dilatation.