ArticleThe American journal of case reports2026
Secondary Thoracoabdominal Aortic Replacement Following Total Arch Repair With a Sutureless Integrated Stented Graft in Marfan Syndrome: A Case Report.
Article in The American journal of case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND Secondary thoracoabdominal aortic replacement after a total arch repair is a complex procedure that has a risk of complications such as stroke and renal failure. Patients with Marfan syndrome are more at risk of distal aortic re-interventions. This report describes a 52-year-old woman with Marfan syndrome and a history of type A aortic dissection treated with total arch replacement and frozen elephant trunk implantation using a sutureless integrated stented graft (SISG), who presented 3 years later with a distal aortic dissection aneurysm requiring secondary thoracoabdominal aortic replacement. CASE REPORT A 52-year-old woman with Marfan syndrome underwent ascending aortic and total arch replacement with frozen elephant trunk implantation using a sutureless integrated stented graft (SISG) for acute type A aortic dissection 3 years earlier. One month before the current operation, thoracoabdominal aortic replacement was performed because follow-up imaging demonstrated false lumen expansion of the residual thoracoabdominal aortic dissection, with a maximal diameter exceeding 5.5 cm. Intraoperatively, significant false lumen thrombosis and obliteration were observed in the elephant trunk region. A 2-cm unstented graft segment at the distal end of the elephant trunk facilitated proximal anastomosis in the current surgery. Given the patient's Marfan syndrome, all branch vessels were reconstructed. Follow-up aortic computed tomography demonstrated satisfactory morphology, and the patient was discharged 2 weeks after surgery. CONCLUSIONS This case demonstrates successful staged repair of residual thoracoabdominal aortic dissection following initial total arch replacement using a SISG in a patient with Marfan syndrome. The sutureless graft facilitated secondary procedure by providing a suitable proximal landing zone, with complete false lumen thrombosis confirming effective primary repair and favorable outcomes.
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