1/31. Coronary ostial aneurysms after composite graft replacement.Coronary ostial aneurysms after composite graft replacement of the ascending aorta and aortic valve is a rare complication. We report two patients with marfan syndrome who developed coronary ostial aneurysms at the sites of the coronary anastomosis, presumably because of oversized windows made in the graft. They were successfully treated by redo composite graft replacement. To prevent this complication, it is important to consider that the hole made in the tube graft should not be larger than the diameter of the respective coronary ostium to avoid exposure of the diseased aortic wall to the circulating blood as much as possible, and that the suture used to anastomose the coronary buttons should pass through the rim of the ostium rather than through the aortic wall surrounding it.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
2/31. Coronary artery aneurysm in a patient with marfan syndrome.True aneurysm of the coronary artery in marfan syndrome is very rare. We present a patient with marfan syndrome who had aneurysms from the ascending aorta to the thoracoabdominal aorta and a large aneurysm of the left main coronary artery after an original Bentall operation. Prosthetic graft replacement of total aorta, coronary artery bypass grafting, and removal of the aneurysm of the left main coronary artery were successfully performed.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
3/31. Emergency management of spontaneous coronary artery dissection.Six cases of spontaneous coronary arteries dissection are reported. In one patient, triple vessel spontaneous coronary artery dissection was identified. Another patient presented spontaneous left main coronary artery dissection. In one case we found the spontaneous dissection of the left anterior descending artery associated with distal aortic arch dissection. These conditions are very rare and may present a surgical dilemma. Causative factors and underlying pathology are clarified. Prompt diagnosis and surgical intervention is safe and effective. Early recognition of left main coronary artery dissection or three-vessel dissection is essential because urgent coronary artery bypass grafting may be life saving.- - - - - - - - - - ranking = 2.25keywords = coronary (Clic here for more details about this article) |
4/31. Successful treatment in a patient with Takayasu's arteritis and marfan syndrome.We report an unusual case of concomitant Takayasu's arteritis and marfan syndrome manifesting left main coronary ostial obstruction and annuloaortic ectasia. Simultaneous surgical treatment consisting of left coronary ostium endarterectomy, coronary artery bypass grafting, and Bentall operation was performed. This case is unique in that the cardiovascular manifestations of Takayasu's arteritis and marfan syndrome were both simultaneously presented and surgically treated.- - - - - - - - - - ranking = 0.75keywords = coronary (Clic here for more details about this article) |
5/31. Modified aortic root remodeling for annuloaortic ectasia with abnormal coronary take-off.The abnormality of coronary arterial take-off is a limiting factor for a successful aortic valve sparing procedure. We present a 13-year-old boy, with marfan syndrome and annuloaortic ectasia, whose coronary take-off was found to be abnormal during surgery. Two adjacent coronary orifices were located in the left coronary sinus and very close to the right-left commissure. A modified aortic remodeling procedure was successfully performed without translocation of the coronary artery.- - - - - - - - - - ranking = 2.25keywords = coronary (Clic here for more details about this article) |
6/31. Treatment of a fistula at the distal anastomosis after Bentall operation with endoluminal covered stent.A 25-year-old Marfan patient was operated on for an acute type A aortic dissection that was complicated twice by false aneurysms at the distal suture line. At the third episode a covered endoprosthesis was inserted in the ascending aorta between the coronary ostia and the inominate artery. The postoperative course was uneventful and a control computed tomographic scan showed complete occlusion of the false aneurysm. This attractive technique should be considered versus an open-heart operation in selected patients.- - - - - - - - - - ranking = 0.25keywords = coronary (Clic here for more details about this article) |
7/31. Aortic insufficiency in a patient with marfan syndrome after aortic root reconstruction with a tailored-sinus graft.A patient with marfan syndrome underwent valve-preserving aortic root reconstruction with a Robicsek-Thubrikar graft. Intraoperative transesophageal echocardiography showed aortic insufficiency after extracorporeal circulation was discontinued. Placing 3 subcommissural annuloplasty sutures corrected the severe aortic insufficiency. Herein, we discuss the mechanism and prevention of aortic regurgitation after aortic root replacement with a new graft that contains pre-designed aortic sinuses.- - - - - - - - - - ranking = 0.011070080994259keywords = circulation (Clic here for more details about this article) |
8/31. Repair of left coronary artery aneurysm, recurrent ascending aortic aneurysm, and mitral valve prolapse 19 years after Bentall's procedure in a patient with marfan syndrome.A 45-year-old female with marfan syndrome had a Bentall's procedure performed 19 years ago. She presented with a 4-year history of gradually worsening dyspnea and decreasing exercise tolerance. Investigations revealed severe mitral valve prolapse, a left main stem coronary artery (LMSCA) aneurysm, and a recurrent aneurysm of the ascending aorta. The mitral valve was replaced and the aortic aneurysmal sac and the LMSCA aneurysm were then repaired by a modified Bentall procedure. The patient made an uneventful recovery and was discharged home.- - - - - - - - - - ranking = 1.25keywords = coronary (Clic here for more details about this article) |
9/31. marfan syndrome as a predisposing factor for traumatic aortic insufficiency.Despite the increase in car accidents, aortic valve injury from blunt trauma remains rare. In one case, a 30-year-old Marfan male, who was under observation at our outpatient clinic, suffered from aortic regurgitation due to a tear in the left coronary cusp of a previously echocardiographically normal valve. Acute ventricular failure demanded surgical management within 3 days after an automobile accident. The case was successfully treated by replacement of the aortic valve with a no. 23 Sorin Bicarbon prosthesis. The patient fully recovered and experienced an uneventful 6 months of follow-up.- - - - - - - - - - ranking = 0.25keywords = coronary (Clic here for more details about this article) |
10/31. Simple modification of "T. David-V" valve-sparing aortic root replacement to create graft pseudosinuses.The absence of sinuses of Valsalva is postulated to perturb coronary flow patterns and to create abnormal leaflet stresses, which theoretically may limit the long-term durability of valve-sparing aortic root replacement with the original Tirone David-I reimplantation technique with a cylindrical tube graft. David developed the "T. David-V" procedure in 2001; it creates large billowing Dacron pseudosinuses while retaining the reimplantation concept. To illustrate a simple modification of the T. David-V technique, we describe a patient with Marfan's syndrome who underwent valve-sparing aortic root replacement with 1 large and 1 small graft to create pseudosinuses in the Dacron graft, to facilitate suturing the valve inside the graft, and to make the distal graft-to-aorta anastomosis a better size match.- - - - - - - - - - ranking = 0.25keywords = coronary (Clic here for more details about this article) |
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