[A simultaneous operation of aortic root, arch replacement, and sternal elevation for Marfan's syndrome--a case...

A 42-year-old male was transferred to our institution by his family doctor because of suspected type A aortic dissection with cardiac tamponade. His physical constitution gave the appearance of Marfan's syndrome. Contrast CT revealed DeBaky type 1 aortic dissection. Angiography detected an Annulo-aortic ectasia complicated by an aortic regurgitation (AR) grade IV. He also suffered from a severe funnel chest. We performed simultaneous procedures of aortic root, arch replacement, and sternal elevation. Upon operation, a staged aortic clamp technique was employed to reduce the period of cardiac arrest. In the sternal elevation, the bilateral internal thoracic arteries were preserved. Post operative course was uneventful. We consider it effective to employ the staged aortic clamp technique in a reconstruction of the entire thoracic aorta in the case of poor cardiac function and to preserve the bilateral internal thoracic arteries in sternal elevation in order to prevent infection.