Total Aortic Replacement for Chronic Aortic Dissection Occurring in Patients with and without Marfanʼs Syndrome

2 patients with chronic dissecting aortic aneurysm, moderately severe aortic insufficiency producing increasing heart strain, and progressive enlargement of the false lumen despite ideal blood pressure control. One patient had Marfan's syndrome.

Two-stage total aortic replacement including aortic valve. Stage 1: replacement of aortic valve, ascending and transverse aortic arch with composite valve-graft under cardiopulmonary bypass, profound hypothermia, and circulatory arrest. Stage 2: replacement of entire descending thoracic and abdominal aortic segments with a graft.

Survival and procedural successhard clinical