Rescue surgery 19 years after composite root and hemiarch replacement

Area of Science:

• Cardiovascular Surgery
• Aortic Diseases
• Marfan Syndrome

Background:

• A 59-year-old male with Marfan syndrome presented with acute chest pain.
• History of complex type A aortic dissection repair 19 years prior, including composite aortic root replacement with a mechanical valve.
• Computed tomography revealed distal ascending aortic anastomosis perforation and complete avulsion of both coronary ostia.

Purpose of the Study:

• To describe a complex case of aortic dissection complication in a patient with Marfan syndrome.
• To highlight the successful management of acute aortic pathology with coronary ostia avulsion.
• To present the application of the modified Cabrol technique in a rescue surgery scenario.

Main Methods:

• Immediate computed tomography for diagnosis.
• Emergency surgical intervention.
• Ascending aorta and arch replacement utilizing a modified Cabrol technique.

Main Results:

• Successful rescue surgery was performed.
• The patient's ascending aorta and arch were replaced.
• The modified Cabrol technique was employed for repair.

Conclusions:

• The modified Cabrol technique can be effective in managing complex aortic dissection complications, including coronary ostia avulsion.
• Prompt surgical intervention is critical for patients with Marfan syndrome presenting with acute aortic emergencies.
• This case demonstrates a successful outcome in a high-risk surgical scenario.