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Case Report

Bentall with Total Arch Replacement usingLong Elephant Trunk (TARLET) for Marfan’s Syndrome

Swati Shah 

Chief Anaesthesiologist, Asian Heart Institute, Bandra-Kurla Complex, Mumbai 400 051, India; swati285@yahoo.com

Author for Correspondence :

Swati Shah

Chief Anaesthesiologist, Asian Heart Institute, Bandra-Kurla Complex, Mumbai 400 051, India; swati285@yahoo.com 

Received Date: 2017-09-15,
Accepted Date: 2017-10-15,
Published Date: 2017-10-31
Year: 2017, Volume: 7, Issue: 4, Page no. 158-160, DOI: 10.26463/rjms.7_4_2
Views: 807, Downloads: 3
Licensing Information:
CC BY NC 4.0 ICON
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0.
Abstract

Aortic arch surgery requires meticulous teamwork in the true perioperative sense. Planning and communication at all phases from preoperative evaluation, through intraoperative management, to postoperative care should be well coordinated between surgical, anesthesia, perfusion, and intensive care unit teams. This case report discusses intraoperative management of a case of Marfan’s syndrome with anomalous right subclavian artery from the anesthesiologist’s perspective. Bentall with Total Arch Replacement using Long Elephant Trunk for Marfan’s syndrome with anomalous right subclavian artery was performed. Stanford type A dissection of the aorta extending down till the bifurcation can affect multi-organs system besides brain. An intraoperative strategy should aim multi-organ protection to avoid morbidity and mortality. Cerebral protection using retrograde and antegrade cerebral perfusion and systemic hypothermic circulatory arrest to protect multi organs made surgery and post-operative recovery uneventful.

<p>Aortic arch surgery requires meticulous teamwork in the true perioperative sense. Planning and communication at all phases from preoperative evaluation, through intraoperative management, to postoperative care should be well coordinated between surgical, anesthesia, perfusion, and intensive care unit teams. This case report discusses intraoperative management of a case of Marfan&rsquo;s syndrome with anomalous right subclavian artery from the anesthesiologist&rsquo;s perspective. Bentall with Total Arch Replacement using Long Elephant Trunk for Marfan&rsquo;s syndrome with anomalous right subclavian artery was performed. Stanford type A dissection of the aorta extending down till the bifurcation can affect multi-organs system besides brain. An intraoperative strategy should aim multi-organ protection to avoid morbidity and mortality. Cerebral protection using retrograde and antegrade cerebral perfusion and systemic hypothermic circulatory arrest to protect multi organs made surgery and post-operative recovery uneventful.</p>
Keywords
Aortic Root Surgery, Cardio-Pulmonary Bypass, Elephant Trunk, Stanford Type A Dissection
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