Operation for Acute Aortic Dissection 13 Years after Operation for Funnel Chest in Marfan Syndrome

(Department of Cardiovascular Surgery, Iwakuni National Hospital, Iwakuni, Japan and Department of Cardiovascular Surgery, Tsuyama Central Hospital*, Tsuyama, Japan)

Yuji Kanaoka* Kazuo Tanemoto Takashi Murakami
Keiichiro Kuroki Hitoshi Minami Masahiko Kuinose
Abnormalities of the skeleton and joint as well as ophthalmic symptoms and cardiovascular abnormalities are found in Marfan's syndrome, one of the connective tissue diseases associated with autosomal dominant inheritance. A 34-year-old man was operated on for Stanford type A acute aortic dissection that developed 13 years after sternal turnover surgery for funnel chest. After approaching by median incision made on the sternum, composite graft replacement and aortic arch replacement were performed. After surgery, the sternum at the site of reflections became unsteady, causing flail chest, which required internal fixation with an artificial respirator for 15 days. A patient with Marfan's syndrome may undergo cardiovascular operation twice or more throughout his lifetime. Where a longitudinal incision is made on the sternum after operation on the funnel chest, care should be exercised even if it is a long time after surgery. In this sense, minimal invasive surgery with a steel bar inserted percutaneously, a surgical technique that has come to be used recently, should be useful.
@Jpn. J. Cardiovasc. Surg. 30: 33-35 (2001)