title: Descending aortic replacement after Nuss for pectus excavatum in a Marfan patient-Case report.
abstract: BACKGROUND
  The Nuss procedure for pectus excavatum (PE) repair has been successfully performed in Marfan syndrome (MFS) patients however there is concern for future risk of aortic dilation/rupture and need for emergent access with support bars in place.
  
  
  METHODS
  We present a 45 year-old male with MFS that required descending aortic replacement shortly after modified Nuss repair.
  
  
  CONCLUSIONS
  The majority of MFS patients have severe PE and repair with the Nuss procedure is not uncommon. The risk for life threatening aortic dilation, dissection, or rupture in such patients is a concern when utilizing this technique. Our work has been reported in line with the CARE criteria.
  
  
  CONCLUSIONS
  Nuss repair should be considered in MFS patients with technique modifications and careful consideration of future risk of aortic dilation and rupture.
authors.affiliation: Division of Cardiothoracic Surgery, Mayo Clinic Arizona, United States. Electronic address: Jaroszewski.Dawn@mayo.edu.
authors.forename: Dawn
authors.initials: D
authors.lastname: Jaroszewski
authors.affiliation: Division of Cardiothoracic Surgery, Mayo Clinic Arizona, United States.
authors.forename: MennatAllah
authors.initials: M
authors.lastname: Ewais
authors.affiliation: Division of Cardiothoracic Surgery, Mayo Clinic Arizona, United States.
authors.forename: Patrick
authors.initials: P
authors.lastname: DeValeria
authors.affiliation: Department of Radiology Mayo Clinic Arizona, United States.
authors.forename: Michael
authors.initials: M
authors.lastname: Gotway
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Stanford University Medical School, United States.
authors.forename: D
authors.initials: D
authors.lastname: Craig Miller
keywords: Descending aorta; Marfan syndrome; Pectus excavatum