Pulmonary venous obstruction in a patient with Marfan syndrome: Rare presentation of an expanding dissecting descending thoracic aortic aneurysm with.

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Presentation transcript:

Pulmonary venous obstruction in a patient with Marfan syndrome: Rare presentation of an expanding dissecting descending thoracic aortic aneurysm with annuloaortic ectasia Yoshikatsu Saiki, MD, PhD, Shunsuke Kawamoto, MD, PhD, Junetsu Akasaka, MD, PhD, Naotaka Motoyoshi, MD, PhD, Sadahiro Sai, MD, PhD, Koichi Tabayashi, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 137, Issue 5, Pages 1282-1284 (May 2009) DOI: 10.1016/j.jtcvs.2008.01.043 Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Preoperative imaging. A, Chest radiograph showing severe congestion in right lung. B, Computed tomographic scan of left atrial region showing right pulmonary vein being compressed by surrounding components: dissecting descending thoracic aorta, enlarged aortic root, and deformed chest wall. Ao. Root, Aortic root; PV, pulmonary vein; Dec. Ao., descending thoracic aorta. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1282-1284DOI: (10.1016/j.jtcvs.2008.01.043) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Schematic diagrams illustrating operative technique. A, Prosthetic vascular grafts were anastomosed to sides of left axillary, right subclavian, and left femoral arteries. Bilateral anterior thoracotomy through fourth intercostal space with limited incision on right side, transverse sternotomy, transection of fifth and sixth ribs posteriorly, and further extension of sixth intercostal space were used to expose entire thoracic aorta. B, Final appearance of replaced thoracic aorta, with reconstruction of eighth, ninth, and tenth intercostal arteries (ICA). The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1282-1284DOI: (10.1016/j.jtcvs.2008.01.043) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions