Key result
Chronic anticoagulation may accelerate recurrent aortic dissection progression in Marfan syndrome.
Why the study?
The potential effects of chronic anticoagulant therapy on the progression of recurrent aortic dissection in patients with Marfan's syndrome are unclear.
Does chronic anticoagulant therapy accelerate the progression of recurrent aortic dissection in patients with Marfan's syndrome?
Case Report (n=1)
Does chronic anticoagulant therapy accelerate the progression of recurrent aortic dissection in patients with Marfan's syndrome?
Chronic anticoagulant therapy may accelerate the progression of recurrent aortic dissection in patients with Marfan's syndrome, suggesting a potential benefit of valve-sparing procedures to avoid long-term anticoagulation.
Supports caution with anticoagulation in Marfan patients with recurrent dissection; leaves open whether valve-sparing procedures mitigate risk.
Recent reports support the role of a valve-sparing procedure in ascending aortic dissection in patients with Marfans syndrome. A 49-year-old woman with Marfans syndrome and prior aortic aneurysm repaired with a composite graft presented with sudden-onset chest pain. Following an initial negative computed tomographic (CT) scan, a long dissection involving the descending thoracic and abdominal aorta was discovered on a repeat CT scan a few hours later. Symptoms improved gradually with optimal medical management and the patient was discharged home on anticoagulant therapy. Although no direct cause-and-effect relationship can be established, chronic anticoagulant therapy may accelerate the progression of recurrent dissection in these patients. A valve-sparing procedure should be considered in eligible patients with Marfans syndrome who need operative correction to avoid possible future untoward effects of long-term anticoagulant therapy.
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Kantelhardt et al. (2003) conducted a case report in Marfan's syndrome with recurrent aortic dissection (n=1). Anticoagulant therapy was evaluated on Progression of recurrent aortic dissection. Chronic anticoagulant therapy may accelerate the progression of recurrent aortic dissection in patients with Marfan's syndrome.
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