ABSTRACT
Redo cardiac operation is extremely hazardous because of adhesions of underlying structures between the sternum and the heart. Total body perfusion through femoral vessel cannulation in conjunction with endovascular aortic clamping can be achieved using remote access perfusion (RAP) endoclamp catheter prior to opening the sternum. We experienced a patient with Marfan syndrome who underwent redo Bentall operation. A 27-year-old male with Marfan syndrome who had undergone two previous Bentall operations was presented with infective endocarditis and pseudoaneurysm of aorta. Total cardiopulmonary bypass perfusion through RAP catheter before the sternotomy was initiated. Safe insertion and proper positioning of RAP catheter was guided by intraoperative transesophageal echocardiography. The operation was uneventful.