Long-term stable result of using the prosthetic graft as distal landing zone for hybrid procedure of a complicated thoracoabdominal aortic aneurysm dissection with Marfan syndrome_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

JI Zhimin , WANG Tiehao , CHEN Xiyang ,  ZHAO Jichun , WENG Chengxin , HUANG Bin , YUAN Ding , YANG Yi

Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

ZHAO Jichun, Email: zhaojichundoc@163.com

Keywords：

Marfan syndrome; thoracoabdominal aortic aneurysm; dissection; hybrid procedure; distal landing zone

DOI：

10.7507/1007-9424.202103065

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective Reporting a case of hybrid procedure of extensive thoracoabdominal aortic aneurysm (TAAA) with type B dissection due to Marfan syndrome (MFS) using a prosthetic graft as the distal landing zone for stent-graft.Methods Retrospectively summarize in-hospital profiles of a patient for who was diagnosed as MFS complicated with TAAA and type B dissection and admmited to Vascular Surgery Department of West China Hospital in May 2018. A GORE-TEX 18 mm×9 mm Y-shaped graft was sewn side-to-end to the bifurcation of left common iliac artery as the inflow site, and a self-made penta-limb graft was sewn side-to-end to the bifurcation of the 18 mm graft. The visceral and bilateral iliac arteries were reconstructed subsequently. Then, the release of the stent-graft was designed from distal to proximal. The distal part of the stent-graft was anchored into the main body of the 18 mm Y-shaped graft.Results The patient underwent the operation successfully with a duaration of 6 h, blood loss of about 800 mL. No serious postoperative complications occurred. Computed tomography angiography at 2-year follow-up showed that the bypass grafts were patent without endoleak, stent migration, stent infolding or infections of the vessel graft and endograft.Conclusion This modified management of the landing zone could be a proper choice for this kind of rare case as extensive aneurysm or dissection involved in patients with MFS.

Citation： JI Zhimin, WANG Tiehao, CHEN Xiyang, ZHAO Jichun, WENG Chengxin, HUANG Bin, YUAN Ding, YANG Yi. Long-term stable result of using the prosthetic graft as distal landing zone for hybrid procedure of a complicated thoracoabdominal aortic aneurysm dissection with Marfan syndrome. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(6): 794-798. doi: 10.7507/1007-9424.202103065 Copy

1.	Ghanta RK, Green SY, Price MD, et al. Midterm survival and quality of life after extent ii thoracoabdominal aortic repair in Marfan syndrome. Ann Thorac Surg, 2016, 101(4): 1402-1409.
2.	Taurino M, Ficarelli R, Rizzo L, et al. Hybrid treatment for thoracoabdominal aortic aneurysms in patients with Marfan syndrome. Ann Vasc Surg, 2015, 29(3): 595. e5-9.
3.	Keane MG, Pyeritz RE. Medical management of Marfan syndrome. Circulation, 2008, 117(21): 2802-2813.
4.	Quintana E, Bruce C, Sabate Rotes A, et al. Anatomical aortic reconstruction in Marfan disease: dismantling of a hybrid repair. Eur J Cardiothorac Surg, 2015, 48(3): 507-509.
5.	LaBounty TM, Eagle KA. Distal aorta: the next frontier in managing Marfan syndrome aortic disease. J Am Coll Cardiol, 2015, 65(3): 255-256.
6.	Damrauer SM, Fairman RM. Visceral debranching for the treatment of thoracoabdominal aortic aneurysms: based on a presentation at the 2013 VEITH symposium, November 19-23, 2013 (New York, NY, USA). Aorta (Stamford), 2015, 3(2): 67-74.
7.	Schoenhoff FS, Schmidli J. TEVAR in patients with Marfan syndrome: from bailout to strategy. Eur J Vasc Endovasc Surg, 2020, 59(4): 586.
8.	Pellenc Q, Roussel A, Senemaud J, et al. Staged hybrid repair of type Ⅱ thoracoabdominal aneurysms. J Vasc Surg, 2020, S0741-5214(20): 32596-32599.
9.	Aru RG, Richie CD, Badia DJ, et al. Hybrid repair of type b aortic dissection with thoracoabdominal aortic aneurysmal degeneration in the setting of Marfan syndrome. Vasc Endovascular Surg, 2021 Feb 25, Epub ahead of print.
10.	Goldfinger JZ, Halperin JL, Marin ML, et al. Thoracic aortic aneurysm and dissection. J Am Coll Cardiol, 2014, 64(16): 1725-1739.
11.	Gelpi G, Mazzaccaro D, Romagnoni C, et al. Hybrid endovascular treatment of an aortic root and thoracoabdominal aneurysm in a high-risk patient with Marfan syndrome. Vasc Endovascular Surg, 2013, 47(4): 300-303.
12.	Nakanishi Y, Yuzaki M, Honda K, et al. Staged hybrid aortic procedure for chronic type B aortic dissection in two patients with Marfan syndrome. Gen Thorac Cardiovasc Surg, 2020, 68(12): 1472-1474.
13.	Romaniello F, Mazzaglia D, Pellegrino A, et al. Aortopathy in Marfan syndrome: an update. Cardiovasc Pathol, 2014, 23(5): 261-266.
14.	Collins RT, Phomakay V, Zarate YA, et al. Impact of aortic aneurysm on hospitalizations in patients with marfan syndrome: a multi-institutional study. Pediatr Cardiol, 2015, 36(1): 132-139.
15.	Waterman AL, Feezor RJ, Lee WA, et al. Endovascular treatment of acute and chronic aortic pathology in patients with Marfan syndrome. J Vasc Surg, 2012, 55(5): 1234-1240.
16.	Di Luozzo G, Geisbüsch S, Lin HM, et al. Open repair of descending and thoracoabdominal aortic aneurysms and dissections in patients aged younger than 60 years: superior to endovascular repair? Ann Thorac Surg, 2013, 95(1): 12-19.
17.	Kouchoukos NT, Kulik A, Castner CF. Open thoracoabdominal aortic repair for chronic type B dissection. J Thorac Cardiovasc Surg, 2015, 149(2 Suppl): S125-S129.
18.	Zoli S, Etz CD, Roder F, et al. Long-term survival after open repair of chronic distal aortic dissection. Ann Thorac Surg, 2010, 89(5): 1458-1466.
19.	Wang W, Piao H, Wang Y, et al. Long-term outcomes of hybrid technique of complicated type b aortic dissection. Ann Thorac Surg, 2019, 107(5): 1319-1325.
20.	Clare R, Jorgensen J, Brar SS. Open versus endovascular or hybrid thoracic aortic aneurysm repair. Curr Atheroscler Rep, 2016, 18(10): 60.

1. Ghanta RK, Green SY, Price MD, et al. Midterm survival and quality of life after extent ii thoracoabdominal aortic repair in Marfan syndrome. Ann Thorac Surg, 2016, 101(4): 1402-1409.
2. Taurino M, Ficarelli R, Rizzo L, et al. Hybrid treatment for thoracoabdominal aortic aneurysms in patients with Marfan syndrome. Ann Vasc Surg, 2015, 29(3): 595. e5-9.
3. Keane MG, Pyeritz RE. Medical management of Marfan syndrome. Circulation, 2008, 117(21): 2802-2813.
4. Quintana E, Bruce C, Sabate Rotes A, et al. Anatomical aortic reconstruction in Marfan disease: dismantling of a hybrid repair. Eur J Cardiothorac Surg, 2015, 48(3): 507-509.
5. LaBounty TM, Eagle KA. Distal aorta: the next frontier in managing Marfan syndrome aortic disease. J Am Coll Cardiol, 2015, 65(3): 255-256.
6. Damrauer SM, Fairman RM. Visceral debranching for the treatment of thoracoabdominal aortic aneurysms: based on a presentation at the 2013 VEITH symposium, November 19-23, 2013 (New York, NY, USA). Aorta (Stamford), 2015, 3(2): 67-74.
7. Schoenhoff FS, Schmidli J. TEVAR in patients with Marfan syndrome: from bailout to strategy. Eur J Vasc Endovasc Surg, 2020, 59(4): 586.
8. Pellenc Q, Roussel A, Senemaud J, et al. Staged hybrid repair of type Ⅱ thoracoabdominal aneurysms. J Vasc Surg, 2020, S0741-5214(20): 32596-32599.
9. Aru RG, Richie CD, Badia DJ, et al. Hybrid repair of type b aortic dissection with thoracoabdominal aortic aneurysmal degeneration in the setting of Marfan syndrome. Vasc Endovascular Surg, 2021 Feb 25, Epub ahead of print.
10. Goldfinger JZ, Halperin JL, Marin ML, et al. Thoracic aortic aneurysm and dissection. J Am Coll Cardiol, 2014, 64(16): 1725-1739.
11. Gelpi G, Mazzaccaro D, Romagnoni C, et al. Hybrid endovascular treatment of an aortic root and thoracoabdominal aneurysm in a high-risk patient with Marfan syndrome. Vasc Endovascular Surg, 2013, 47(4): 300-303.
12. Nakanishi Y, Yuzaki M, Honda K, et al. Staged hybrid aortic procedure for chronic type B aortic dissection in two patients with Marfan syndrome. Gen Thorac Cardiovasc Surg, 2020, 68(12): 1472-1474.
13. Romaniello F, Mazzaglia D, Pellegrino A, et al. Aortopathy in Marfan syndrome: an update. Cardiovasc Pathol, 2014, 23(5): 261-266.
14. Collins RT, Phomakay V, Zarate YA, et al. Impact of aortic aneurysm on hospitalizations in patients with marfan syndrome: a multi-institutional study. Pediatr Cardiol, 2015, 36(1): 132-139.
15. Waterman AL, Feezor RJ, Lee WA, et al. Endovascular treatment of acute and chronic aortic pathology in patients with Marfan syndrome. J Vasc Surg, 2012, 55(5): 1234-1240.
16. Di Luozzo G, Geisbüsch S, Lin HM, et al. Open repair of descending and thoracoabdominal aortic aneurysms and dissections in patients aged younger than 60 years: superior to endovascular repair? Ann Thorac Surg, 2013, 95(1): 12-19.
17. Kouchoukos NT, Kulik A, Castner CF. Open thoracoabdominal aortic repair for chronic type B dissection. J Thorac Cardiovasc Surg, 2015, 149(2 Suppl): S125-S129.
18. Zoli S, Etz CD, Roder F, et al. Long-term survival after open repair of chronic distal aortic dissection. Ann Thorac Surg, 2010, 89(5): 1458-1466.
19. Wang W, Piao H, Wang Y, et al. Long-term outcomes of hybrid technique of complicated type b aortic dissection. Ann Thorac Surg, 2019, 107(5): 1319-1325.
20. Clare R, Jorgensen J, Brar SS. Open versus endovascular or hybrid thoracic aortic aneurysm repair. Curr Atheroscler Rep, 2016, 18(10): 60.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Long-term stable result of using the prosthetic graft as distal landing zone for hybrid procedure of a complicated thoracoabdominal aortic aneurysm dissection with Marfan syndrome

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content