Giant left coronary ostial aneurysm after modified Bentall procedure in a Marfan patient
Kazuma Okamoto1, Filip P Casselman, Raphael De Geest
1Department of Cardiovascular and Thoracic Surgery, OLV Clinic, Aalst, Belgium.
Abstract:
We performed surgical repair of a giant left coronary ostial aneurysm after aortic root replacement using composite valve graft (modified Bentall procedure) in a patient with Marfan syndrome. Aneurysmal formation in the left main stem itself is very rare. In order to avoid mobilizing the coronary ostium from severe adhesions after previous surgery and to reduce the tension on the anastomosis, the left main trunk was reconstructed using an interposition Dacron graft. In aortic root surgeries in Marfan patients, the size of the side hole on the composite graft should be kept relatively small to fit the diameter of the native coronary arteries for prevention of coronary buttons from forming aneurysms at the level of the coronary button anastomosis. In addition, close observation to the coronary button anastomosis is indispensable in postoperative check-up.
Related Concept Videos
Aneurysm I: Introduction
Aortic Regurgitation III: Medical Management
Aneurysm III: Interprofessional Care
Mitral Stenosis I: Introduction
Aortic Regurgitation I: Introduction
Aortic Regurgitation II: Clinical Features and Diagnostic Tests


