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

Triple-barrel dissecting thoracic aorta sizing 10cm showed in (A) axial cut and (B) Sagital cut. (C) The schematic drawing shows previous hemiarch repair and current dissecting thoracoabdominal aortic aneurysm on the projection of an ordinary chest film.

(A) The intraoperative photo shows complex revascularization. I: intercostal graft; L: lumbar graft, R: the graft to left renal artery; V: the graft to celiac trunk, superior mesenteric and right renal arteries. (B) The schematic drawing simplifies the operative procedures. (C) Postoperative magnetic resonance image shows the reconstructed result. Notify the occluded intercostal graft remnant.