Page 14 - Virtual Vascular Vol 13

Marfan Syndrome AAA

This is a 43-year-old lady with Marfan syndrome with previous Type A aortic dissection requiring
emergency Bentall procedure 20 years ago. She underwent two subsequent open thoracic aortic
operations for dissecting aortic aneurysms over the ascending and descending thoracic aorta some
10+ years ago.

She presented to us with an abdominal aortic aneurysm which gradually increase in size over the
years. Surgical intervention was decided although the aneurysm is still below 5cm (young age with
increasing size of aneurysm and Marfan syndrome).

CT angiogram showed the aneurysm is close to the left renal artery with an acute kink over the
infrarenal neck. In view of her young age, connective tissue disease and the acute kink at the infra-

renal neck- Endovascular stent graft repair is deemed inappropriate. She underwent open aneurysm
repair with aortic clamp above the left renal artery intraoperatively and the graft anastomosis just
inferior to the left renal artery.

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