Total aortic replacement in a patient with extensive thoracoabdominal aortic aneurysm--a case report

A 35-year-old woman with a form fruste of Marfan's syndrome, presented the extensive thoracoabdominal aortic aneurysm. CT scan, MRI and aortogram revealed that she had a true aneurysm of ascending aorta and aortic arch and chronic DeBakey IIIb dissecting aneurysm extending throughout the descending thoracic and abdominal aorta. The surgical treatment was consisting of two staged operations. At the first operation, ascending aorta and aortic arch were reconstructed under cardiopulmonary bypass and selective cerebral perfusion. Elephant trunk method was employed for the second operation. The second operation was performed by graft replacement of the entire descending thoracic and abdominal aorta with reattachment of intercostal and visceral arteries. She discharged the hospital without any complication including paraplegia.