title: Expanding arch aneurysm causing a "kink" in a Bentall graft and heart failure.
abstract: Marfan syndrome is associated with a high incidence of aortic root aneurysm and life-threatening aortic dissection. With the successful use of surgical aortic root replacement, dissection-related mortality has been significantly reduced. We present the case of a patient with Marfan syndrome who presented with heart failure secondary to an unusual graft-related complication 14 years after a Bentall procedure. Investigations revealed a supra-aortic stenosis resulting from a kink in the Bentall graft caused by pressure from an expanding aortic arch aneurysm. The patient underwent surgery with improvement in his ejection fraction and heart failure symptoms.
authors.affiliation: Division of Cardiology, Department of Radiology, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada. mahaabdulrahman@hotmail.com
authors.forename: Maha A
authors.initials: MA
authors.lastname: Al-Mohaissen
authors.forename: Peter
authors.initials: P
authors.lastname: Skarsgard
authors.forename: Clarence
authors.initials: C
authors.lastname: Khoo
authors.forename: Sean A
authors.initials: SA
authors.lastname: Virani
authors.forename: Brad
authors.initials: B
authors.lastname: Munt
authors.forename: Jonathon
authors.initials: J
authors.lastname: Leipsic
authors.forename: Andrew
authors.initials: A
authors.lastname: Ignaszewski
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000601:surgery*; D001011:Aorta / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications*; D001021:Aortic Valve / Q000601:surgery; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D008297:Male; D008382:Marfan Syndrome / Q000150:complications*; D014694:Ventricular Outflow Obstruction / Q000209:etiology