Key result
Reoperative aortic root replacement for late Marfan syndrome complications is outlined in a contemporary series.
Why the study?
Reoperative aortic root surgery in patients with Marfan syndrome is rare and contemporary experiences with these procedures are difficult to assess due to low clinical volume and limited published reports.
This paper describes a contemporary institutional experience and operative approach for the rare and complex procedure of reoperative aortic root replacement in patients with Marfan syndrome.
Reoperative root replacement in Marfan syndrome remains high-risk; this case report leaves open the need for multicenter outcome data.
Aortic root aneurysm is the most common cardiovascular manifestation requiring surgical intervention in patients with Marfan syndrome (MFS), a heritable thoracic aortic disease. Elective replacement of the aortic root is the treatment of choice for patients with aneurysmal complications of the aortic root and ascending aorta. There are two basic approaches to aortic root replacement: valve-sparing (VS) and valve-replacing (VR) techniques. After successful aortic root replacement surgery, several patients with MFS may develop a late complication related to their aortic disease process, such as developing a pseudoaneurysm of the coronary artery reattachment buttons, aneurysmal expansion, or aortic dissection in the remaining native aorta. These patients may also develop other late complications that are not specifically related to the heritable thoracic aortic disease, such as infections that can lead to dehiscence of some or all of the distal or proximal anastomosis. Because these complications are rare, the clinical volume of reoperations of the aortic root in patients with MFS is low, making it difficult to assess contemporary experiences with these procedures. Only a few published reports have examined reoperative aortic root surgery in patients with MFS, each of which had only a small series of patients. Herein, we describe our contemporary experience with reoperative aortic root replacement in patients with MFS and provide our operative approach for these uncommon procedures.
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Orozco‐Sevilla et al. (2018) studied Marfan syndrome. Reoperative aortic root replacement was evaluated. Reoperative aortic root replacement in patients with Marfan syndrome is described based on contemporary institutional experience, highlighting operative approaches for late complications.
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