Replacement of the mitral valve, aortic valve, and ascending aorta with coronary transplantation in a child with the Marfan syndrome

A girl with the Marfan syndrome is described who developed mitral regurgitation, an aneurysm of the ascending aorta, and severe aortic regurgitation. Complete surgical correction required mitral valve, aortic valve, and ascending aorta replacement with transplantation of the origin of the coronary arteries.

The cardiovascular complications of the Marfan syndrome are discussed and the previously described surgical techniques for dealing with aortic or mitral involvement are briefly reviewed. A simpler and safer method for replacement of the complete ascending aorta with coronary artery transplantation is described.

Surgery of Marfan's syndrome and related conditions of the aortic root (annulo-aortic ectasia)

The surgical treatment of 14 patients with annulo-aortic ectasia and aortic valve regurgitation secondary to cystic medial necrosis is presented. Resection of the aneurysm and replacement with a tubular graft, and aortic valve replacement with a rigid prosthesis, are advocated for definitive treatment. Eighty-six per cent of the patients survive and are doing well six months to four and a half years after surgery.