| Operation for Acute Aortic Dissection
13 Years after Operation for Funnel Chest in Marfan Syndrome |
(Department of Cardiovascular Surgery, Iwakuni National
Hospital, Iwakuni, Japan and Department of Cardiovascular Surgery,
Tsuyama Central Hospital*, Tsuyama, Japan)
| Yuji Kanaoka* |
Kazuo Tanemoto |
Takashi Murakami |
| Keiichiro Kuroki |
Hitoshi Minami |
Masahiko Kuinose |
|
Abnormalities of the skeleton and
joint as well as ophthalmic symptoms and cardiovascular abnormalities
are found in Marfan's syndrome, one of the connective tissue
diseases associated with autosomal dominant inheritance. A 34-year-old
man was operated on for Stanford type A acute aortic dissection
that developed 13 years after sternal turnover surgery for funnel
chest. After approaching by median incision made on the sternum,
composite graft replacement and aortic arch replacement were
performed. After surgery, the sternum at the site of reflections
became unsteady, causing flail chest, which required internal
fixation with an artificial respirator for 15 days. A patient
with Marfan's syndrome may undergo cardiovascular operation twice
or more throughout his lifetime. Where a longitudinal incision
is made on the sternum after operation on the funnel chest, care
should be exercised even if it is a long time after surgery.
In this sense, minimal invasive surgery with a steel bar inserted
percutaneously, a surgical technique that has come to be used
recently, should be useful.
Jpn. J. Cardiovasc. Surg. 30: 33-35 (2001) |
|
