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J Thorac Cardiovasc Surg 2009;137:e34-e36
© 2009 The American Association for Thoracic Surgery

Brief Communication

Simultaneous repair for aortic incompetence with annuloaortic ectasia and pectus excavatum by modified Ravitch procedure with pectus bars in an adult patient with Marfan syndrome

Yang Gi Ryu, MD, Man-Jong Baek, MD*, Hyun Koo Kim, MD, Young Ho Choi, MD, Young-Sang Sohn, MD, Hark Jei Kim, MD

Department of Thoracic and Cardiovascular Surgery, Guro Hospital, Korea University Medical Center, Seoul, Republic of Korea

Received for publication July 18, 2008; accepted for publication July 26, 2008.

* Address for reprints: Man-Jong Baek, MD, Department of Thoracic and Cardiovascular Surgery, Guro Hospital, Korea University Medical Center, Guro 2-Dong, Guro-Gu, Seoul, Republic of Korea, 152-703. (Email: mdmjbaek@korea.ac.kr).

The first 20% of the full text of this article appears below.

Concomitant thoracic reconstruction in patients with Marfan syndrome, pectus excavatum, and associated aortic or cardiac surgery poses a major clinical challenge.

Clinical Summary

A 39-year-old man was seen with dyspnea in March 2008. He had no history of musculoskeletal disease or heart disease apart from Marfanoid features according to the Ghent criteria1Go seen on general examination: kyphoscoliosis, pectus excavatum, arachnodactyly, severe myopia, and diastolic murmur on the apex. Routine laboratory values were also unremarkable. Transthoracic and transesophageal echocardiography showed severely dilated ascending aorta, severe aortic regurgitation, moderate mitral and tricuspid regurgitation, and a small type II atrial septal defect. Computed tomographic scans showed a fusiform aneurysm of the proximal ascending aorta with a maximum diameter of 73 mm, severe pectus excavatum (pectus index of 32.6; Figure 1 ), thoracolumbar scoliosis, and dural ectasia of the lumbosacral area.


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  		Figure 1. Preoperative computed tomography of pectus excavatum and annuloaortic ectasia. Axial computed tomographic scan at level of aortic root shows severe depression of sternum and marked dilatation of aortic root, with severe displacement . . . [Full Text of this Article]

 



This article has been cited by other articles:


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 J. Thorac. Cardiovasc. Surg.Home page
N. Rousse, F. Juthier, A. Prat, and A. Wurtz
Staged repair of pectus excavatum during an aortic valve-sparing operation
J. Thorac. Cardiovasc. Surg., May 1, 2011; 141(5): e28 - e30.
[Full Text] [PDF]


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