Acute aortic dissection Stanford A DeBakey type III in patient with suspected Marfan Syndrome: a case report

Abstract

Background: Patients with Marfan syndrome can experience acute aortic dissection 77% with type A and 23% with type B, and 64% suffer from an aneurysm.Case Description: A 45 year old female admitted to intensive care with chest pain onset since 1 day ago, ECG examination shows sinus rhythm with normal axis. Chest x-ray shows dilatation and elongation of aorta with aorta aneurysm suspected. MSCT scan of thoracal shows dilatation of ascending aorta – distal of left subclavian artery – aortic arch – descending aorta – the thoracoabdominal aorta – right and left common iliac artery. On blood examination, we found elevation of D-dimer (3570 µg/L). Patient was given beta-blockers to control heart rate 60 beats per minutes, CCB and ACE inhibitor was given to control systolic below 110 mmHg. After putting so much thought, patient was scheduled for TEVAR procedure.Conclusion: Patients with Marfan syndrome tend to have thoracic aortic aneurysms involving aortic root, ascending aorta, arch, and descending thoracic aorta. TEVAR is minimal invasive procedure and  have good outcome in patient with aortic dissection.