Total Thoracoabdominal Aortic Replacement in a Marfan Patient Following Heart Transplantation and Hemiarch Repair

Patients with Marfan syndrome were a well-known risk population to develop aortic root aneurysm and aortic dissection through entire life span. Repeated operations for ascending, descending and abdominal aortic pathology were not uncommon. We present a case report of a total thoracoabdominal aortic replacement in a Marfan patient following heart transplantation and hemiarch repair. We achieved a successful one-stage replacement of entire thoracoabdominal aorta. The peri-operative course was complicated with delayed, but reversible paraplegia. The surgical approach and strategy of spinal cord protection is discussed.

Keywords: Marfan syndrome, Heart transplantation, Type-B aortic dissection, Thoracoabdominal aneurysm