Abstract
A 35 year-old male with Marfan's syndrome was referred with a fortuitous echographic finding of an abdominal aorta flap. Transthoracic echocardiography showed moderate aortic regurgitation and an aneurysm in the sinus of Valsalva. Computed tomography demonstrated an aneurysm in the sinus of Valsalva 60 mm in size and a DeBakey type IIIb dissection extending from the left subclavian artery to the right common iliac artery. An aortic valve-sparing operation (reimplantation), total aortic arch replacement and the elephant trunk method were used in this patient. An aortic valve-sparing operation is preferable because the patient is young, and has no need for anticoagulant therapy after surgery. The extent of the aortic reconstruction, including the intact aortic arch, was appropriate to prohibit future dilatation of the aortic arch and retrograde dissection from a DeBakey type IIIb dissection. (Jpn J Thorac Cardiovasc Surg 2005;53: 657–660)
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
David TE, Feindel CM. An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta. J Thorac Cardiovasc Surg 1992; 103: 617–22.
Sarsam MA, Yacoub M. Remodeling of the aortic valve anulus. J Thorac Cardiovasc Surg 1993; 105: 435–8.
Yacoub MH, Gehle P, Chandrasekaran V, Birks EJ, Child A, Radley-Smith R. Late results of a valvepreserving operation in patients with aneurysm of the ascending aorta and root. J Thorac Cardiovasc Surg 1980; 115: 1080–90.
David TE, Armstrong S, Ivanov J, Feindel CM, Omran A, Webb G. Results of aortic valve-sparing operations. J Thorac Cardiovasc Surg 2001; 122: 39–46.
David TE. Current practice in Marfan's aortic root surgery: Reconstruction with aortic valve preservation or replacement? What to do with the mitral valve? J Card Surg 1997; 12 (2 Suppl): 147–50.
Sueyoshi E, Sakamoto I, Hayashi K, Yamaguchi T, Imada T. Growth rate of aortic diameter in patients with type B aortic dissection during the chronic phase. Circulation 2004; 110 (11 Suppl 1): II-256–II-61.
Gott VL, Cameron DE, Alejo DE, Greene PS, Shake JG, Caparrelli DJ, et al. Aortic root replacement in 271 Marfan patients: A 24-year experience. Ann Thorac Surg 2002; 73: 438–43.
Kazui T, Yamashita K, Terada H, Washiyama N, Suzuki T, Ohkura K, et al. Late reoperation for proximal aortic and arch complications after previous composite graft replacement in Marfan patients. Ann Thorac Surg 2003; 76: 1203–8.
Tagusari O, Ogino H, Kobayashi J, Bando K, Minatoya K, Sasaki H, et al. Should the transverse aortic arch be replaced simultaneously with aortic root replacement for annuloaortic ectasia in Marfan syndrome? J Thorac Cardiovasc Surg 2004; 127: 1373–80.
Kazui T, Washiyama N, Muhammad BA, Terada H, Yamashita K, Takinami M, et al. Extended total arch replacement for acute type A aortic dissection: Experience with seventy patients. J Thorac Cardiovasc Surg 2000; 119: 558–65.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Shimizu, K., Setozaki, S., Yuasa, S. et al. Aortic valve-sparing operation and a total arch replacement by an elephant trunk method for Marfan’s syndrome with aortic regurgitation and a DeBakey type IIIb dissection. Jpn J Thorac Caridovasc Surg 53, 657–660 (2005). https://doi.org/10.1007/BF02665080
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02665080