title: Total Endovascular Aortic Repair in a Patient with Marfan Syndrome.
abstract: BACKGROUND
  The aim of this study is to describe a total endovascular aortic repair with branched and fenestrated endografts in a young patient with Marfan syndrome and a chronic aortic dissection. Open surgery is the gold standard to treat aortic dissections in patients with aortic disease and Marfan syndrome.
  
  
  METHODS
  In 2000, a 38-year-old man with Marfan syndrome underwent open ascending aorta repair for an acute type A aortic dissection. One year later, a redo sternotomy was performed for aortic valve replacement. In 2013, the patient presented with endocarditis and pulmonary infection, which necessitated tracheostomy and temporary dialysis. In 2014, the first stage of the endovascular repair was performed using an inner branched endograft to exclude a 77-mm distal arch and descending thoracic aortic aneurysm. In 2015, a 63-mm thoracoabdominal aortic aneurysm was excluded by implantation of a 4-fenestrated endograft. Follow-up after both endovascular repairs was uneventful.
  
  
  RESULTS
  Total aortic endovascular repair was successfully performed to treat a patient with arch and thoraco-abdominal aortic aneurysm associated with chronic aortic dissection and Marfan syndrome. The postoperative images confirmed patency of the endograft and its branches, and complete exclusion of the aortic false lumen.
  
  
  CONCLUSIONS
  Endovascular repair is a treatment option in patients with connective tissue disease who are not candidates for open surgery. Long-term follow-up is required to confirm these favorable early outcomes.
authors.affiliation: Aortic Center, Hôpital Cardiologique, CHRU Lille, Lille, France; Department of Cardiovascular Surgery, Fukuoka University, Fukuoka, Japan.
authors.forename: Mau
authors.initials: M
authors.lastname: Amako
authors.affiliation: Aortic Center, Hôpital Cardiologique, CHRU Lille, Lille, France.
authors.forename: Rafaëlle
authors.initials: R
authors.lastname: Spear
authors.affiliation: Aortic Center, Hôpital Cardiologique, CHRU Lille, Lille, France.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Clough
authors.affiliation: Aortic Center, Hôpital Cardiologique, CHRU Lille, Lille, France.
authors.forename: Adrien
authors.initials: A
authors.lastname: Hertault
authors.affiliation: Aortic Center, Hôpital Cardiologique, CHRU Lille, Lille, France.
authors.forename: Richard
authors.initials: R
authors.lastname: Azzaoui
authors.affiliation: Aortic Center, Hôpital Cardiologique, CHRU Lille, Lille, France.
authors.forename: Teresa
authors.initials: T
authors.lastname: Martin-Gonzalez
authors.affiliation: Aortic Center, Hôpital Cardiologique, CHRU Lille, Lille, France.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Sobocinski
authors.affiliation: Aortic Center, Hôpital Cardiologique, CHRU Lille, Lille, France. Electronic address: stephan.haulon@chru-lille.fr.
authors.forename: Stéphan
authors.initials: S
authors.lastname: Haulon
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000295:instrumentation; D006801:Humans; D008297:Male; D008382:Marfan Syndrome / Q000150:complications* / Q000175:diagnosis; D011474:Prosthesis Design; D016896:Treatment Outcome; D014654:Vascular Patency