True Coronary Aneurysms after the Bentall Procedure in a Patient with Marfan Syndrome / 日本心臓血管外科学会雑誌

ABSTRACT

A 55-year-old woman underwent a Bentall operation and total arch replacement 18 years previously, because of chronic aortic dissection (CAD), annuloaortic ectasia (AAE), aortic valve insufficiency (AI), and Marfan syndrome. In 1996, at age 37 years, she was admitted to our hospital with diagnoses of CAD, AAE, AI, and Marfan syndrome. That same year, we performed the Bentall operation and total arch replacement (Carbomedics, 25 mm ; Hemashield, 28 mm). She then underwent Y-graft replacement for an abdominal aortic aneurysm in 2003, descending aorta replacement for a thoracic aortic aneurysm in 2007, and thoracoabdominal aorta replacement for thoracoabdominal aortic aneurysm in 2010. Afterward, both coronary arteries gradually dilated. The diameter of the left coronary artery was 17 mm, while that of the right coronary artery was 25 mm. Accordingly, in 2014, we surgically replaced both coronary aneurysms with the great saphenous vein. Pathological analysis showed that both coronary aneurysms were true aneurysms because the three-layered structure was preserved. We confirmed that the great saphenous vein grafts were patent by three-dimensional computed tomography. She was discharged 17 days postoperatively once her condition stabilized. We report a case of Marfan syndrome with both coronary true aneurysms, because we think this kind of report is very rare.