Descending aortic replacement after Nuss for pectus excavatum in a Marfan patient-Case report

Dawn Jaroszewski; MennatAllah Ewais; Patrick DeValeria; Michael Gotway; D Craig Miller

doi:10.1016/j.ijscr.2016.01.035

Descending aortic replacement after Nuss for pectus excavatum in a Marfan patient-Case report

Int J Surg Case Rep. 2016:21:16-9. doi: 10.1016/j.ijscr.2016.01.035. Epub 2016 Feb 7.

Authors

Dawn Jaroszewski¹, MennatAllah Ewais², Patrick DeValeria², Michael Gotway³, D Craig Miller⁴

Affiliations

¹ Division of Cardiothoracic Surgery, Mayo Clinic Arizona, United States. Electronic address: Jaroszewski.Dawn@mayo.edu.
² Division of Cardiothoracic Surgery, Mayo Clinic Arizona, United States.
³ Department of Radiology Mayo Clinic Arizona, United States.
⁴ Department of Cardiovascular and Thoracic Surgery, Stanford University Medical School, United States.

Abstract

Introduction: The Nuss procedure for pectus excavatum (PE) repair has been successfully performed in Marfan syndrome (MFS) patients however there is concern for future risk of aortic dilation/rupture and need for emergent access with support bars in place.

Case presentation: We present a 45 year-old male with MFS that required descending aortic replacement shortly after modified Nuss repair.

Discussion: The majority of MFS patients have severe PE and repair with the Nuss procedure is not uncommon. The risk for life threatening aortic dilation, dissection, or rupture in such patients is a concern when utilizing this technique. Our work has been reported in line with the CARE criteria.

Conclusion: Nuss repair should be considered in MFS patients with technique modifications and careful consideration of future risk of aortic dilation and rupture.

Keywords: Descending aorta; Marfan syndrome; Pectus excavatum.