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Related Concept Videos

Aneurysm I: Introduction01:30

Aneurysm I: Introduction

An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...

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Intraoperative Type B Aortic Dissection With Malperfusion in a Patient With Marfan Syndrome.

Joseph M Obeid1, Michael Sacca2, Yocheved Strum3

  • 1Department of Surgery, Stony Brook University Hospital, Stony Brook, New York.

Annals of Thoracic Surgery Short Reports
|January 10, 2025
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Summary

This case study details a 72-year-old man with an aortic root aneurysm and Marfan syndrome. He experienced an intraoperative type B aortic dissection, successfully treated with an axillary-bifemoral bypass for lower extremity malperfusion.

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Area of Science:

  • Cardiovascular Surgery
  • Genetics
  • Vascular Surgery

Background:

  • Marfan syndrome is a genetic disorder affecting connective tissue, often leading to aortic root aneurysm.
  • Aortic root aneurysms increase the risk of aortic dissection and related complications.

Observation:

  • A 72-year-old male patient presented with an aortic root aneurysm.
  • The patient was subsequently diagnosed with Marfan syndrome.
  • During surgery, the patient developed an intraoperative type B aortic dissection.

Findings:

  • The type B aortic dissection resulted in lower extremity malperfusion.
  • An axillary-bifemoral extra-anatomic bypass was successfully employed for management.
  • This surgical approach restored perfusion to the lower extremities.

Implications:

  • This case highlights the complex management of aortic dissection in patients with Marfan syndrome.
  • Axillary-bifemoral bypass is a viable option for treating lower extremity malperfusion secondary to aortic dissection.
  • Early diagnosis and tailored surgical strategies are crucial for favorable outcomes in Marfan syndrome patients with aortic pathology.