A Combination of a Modification of Bentall's Procedure, the Elephant Trunk Method and Aortic Arch Replacement for Marfan's Syndrome Using Cardioplegia

(Department of Cardiovascular Surgery, National Toyohashi Higashi Hospital, Aichi, Japan)

Tsuneo Tanaka Yasuhide Ohkawa Masahiro Toyama
Masaki Hashimoto Koji Matsumoto
A 44-year-old woman with Marfan's syndrome presented complaining of severe back pain. Angiography revealed annulo aortic ectasia, aortic regurgitation, acute aoric dissection (DeBakeyIIIb) and distal aortic arch aneurysm. One month after admission, she underwent cardiopulmonary bypass was established through the femoral artery, the superior and inferior vena cava. The heart was arrested by aortic cross clamping and retrograde cold (20) cardioplegia. At first, a modified Bentall's procedure was done in addition to a Carrel patch procedure. After this procedure, the heart was perfused continuously (300ml/min) with warm (37) blood until the end of the cardiopulmonary bypass. The heart recovered a sinus rhythm spontaneously. Subsequently, aortic arch replacement and the elephant trunk method was done with the aid of deep hypothermia and circulatory arrest. The patients is well 1 year after the operation. This technique is useful for patients who require prolonged aortic cross clamping time.
@Jpn. J. Cardiovasc. Surg. 29: 91-93 (2000)