Preoperative magnetic resonance imaging in Marfan syndrome

We report one of the first cases in Israel of composite-graft repair of an aortic aneurysm in Marfan syndrome, in which preoperative evaluation was done noninvasively using magnetic resonance imaging (MRI). Because of the relatively favorable outcome of surgical compared with medical treatment of aortic aneurysm in patients with Marfan syndrome, surgery is now more frequently considered, even in asymptomatic patients. MRI is an excellent diagnostic tool for evaluating the thoracic aorta and has been suggested as a replacement for preoperative cardiac catheterization. In the case presented here, MRI preoperative confirmation of a 6.0-cm aortic aneurysm in an asymptomatic 38-year-old man with Marfan syndrome, was followed by composite ascending aorta and aortic valve replacement. The postoperative course was good. This case supports the view that aortic aneurysm replacement can be performed based on a noninvasive preoperative evaluation using MRI.