Fenestrated Repair of a Type III Thoracoabdominal Aortic Aneurysm in a Patient with Marfan Disease and Degenerated Aortic Dissection

Abstract

Fenestrated repair of thoracoabdominal aneurysms is an acceptable alternative to open repair, especially in patients with high surgical risk. We were referred a patient with Marfan disease who had undergone several open repairs and now had a degenerated chronic aortic dissection. He refused an open operation because of his experience with multiple open repairs and opted for a fenestrated approach. We performed a custom fenestrated repair of a type III thoracoabdominal aortic aneurysm in a patient with Marfan disease and a degenerated thoracic aorta. A video was made depicting the key steps in this complicated repair. A successful repair was performed. Postoperative computed tomography angiography demonstrated no evidence of any endoleaks, and there was thrombosis of the false lumen. Fenestrated repairs are a reasonable operative modality in patients with connective tissue disorders with a complicated surgical history who are at high risk for an open repair.