Stent-grafts in patients with marfan syndrome.
OBJECTIVE
To explore the safety and feasibility of stent-graft placement in the dissected descending thoracic aorta of patients with Marfan syndrome.


METHODS
Six consecutive patients (4 men; mean age 33+/-15 years, range 24-61) with Marfan syndrome were offered endovascular repair for dissection after previous aortic root repair in 5 and solitary type B dissection in 1.


RESULTS
Transluminal placement of customized Talent stent-grafts was technically successful in all patients, with no 30-day or 1-year intervention-related mortality. Complete abolition of the dissection and reconstruction of the entire dissected aorta was documented in 2 patients. Over a mean 51+/-22-month follow-up (range 12-74), elective conversion to surgical repair was necessary in 2 patients at 22 and 43 months after stent-graft implantation. In a third patient, conversion to surgery is being considered at 74 months after stent-grafting. One patient died suddenly 12 months after endovascular repair.


CONCLUSIONS
Nonsurgical reconstruction of postsurgical distal aortic dissection in patients with Marfan syndrome is feasible and technically successful. Stent-graft placement may either avoid or bridge to repeat surgery of distal aortic dissections after previous aortic root repair. Technical expertise and close postinterventional surveillance appear mandatory and may limit the procedure to centers of competence for aortic diseases.
Ince
Hüseyin
H
Division of Cardiology, University Hospital, Rostock School of Medicine, 18057 Rostock, Germany.
Rehders
Tim C
TC
Petzsch
Michael
M
Kische
Stephan
S
Nienaber
Christoph A
CA
D000328:Adult; D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D021721:Balloon Occlusion / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008382:Marfan Syndrome / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D018570:Risk Assessment; D012494:Sampling Studies; D015607:Stents; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods