Recurrent aortic dissection in Marfan's syndrome: possible effects of anticoagulation.
Recent reports support the role of a valve-sparing procedure in ascending aortic dissection in patients with Marfans syndrome. A 49-year-old woman with Marfans syndrome and prior aortic aneurysm repaired with a composite graft presented with sudden-onset chest pain. Following an initial negative computed tomographic (CT) scan, a long dissection involving the descending thoracic and abdominal aorta was discovered on a repeat CT scan a few hours later. Symptoms improved gradually with optimal medical management and the patient was discharged home on anticoagulant therapy. Although no direct cause-and-effect relationship can be established, chronic anticoagulant therapy may accelerate the progression of recurrent dissection in these patients. A valve-sparing procedure should be considered in eligible patients with Marfans syndrome who need operative correction to avoid possible future untoward effects of long-term anticoagulant therapy.
Kantelhardt
Sven R
SR
Division of Cardiology, Department of Medicine, University of Louisville, Louisville, Kentucky, USA.
Pasnoori
Venkat
V
Varma
Jai
J
Rezazadeh
Arash
A
Dawn
Buddhadeb
B
D000784:Aortic Dissection / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy; D005260:Female; D006801:Humans; D008382:Marfan Syndrome / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008875:Middle Aged; D012008:Recurrence; D014057:Tomography, X-Ray Computed
D000925:Anticoagulants