• Mau Amako, Rafaëlle Spear, Rachel E Clough, Adrien Hertault, Richard Azzaoui, Teresa Martin-Gonzalez, Jonathan Sobocinski, and Stéphan Haulon.
• Aortic Center, Hôpital Cardiologique, CHRU Lille, Lille, France; Department of Cardiovascular Surgery, Fukuoka University, Fukuoka, Japan.
• Ann Vasc Surg. 2017 Feb 1; 39: 289.e9-289.e12.

BackgroundThe aim of this study is to describe a total endovascular aortic repair with branched and fenestrated endografts in a young patient with Marfan syndrome and a chronic aortic dissection. Open surgery is the gold standard to treat aortic dissections in patients with aortic disease and Marfan syndrome.MethodsIn 2000, a 38-year-old man with Marfan syndrome underwent open ascending aorta repair for an acute type A aortic dissection. One year later, a redo sternotomy was performed for aortic valve replacement. In 2013, the patient presented with endocarditis and pulmonary infection, which necessitated tracheostomy and temporary dialysis. In 2014, the first stage of the endovascular repair was performed using an inner branched endograft to exclude a 77-mm distal arch and descending thoracic aortic aneurysm. In 2015, a 63-mm thoracoabdominal aortic aneurysm was excluded by implantation of a 4-fenestrated endograft. Follow-up after both endovascular repairs was uneventful.ResultsTotal aortic endovascular repair was successfully performed to treat a patient with arch and thoraco-abdominal aortic aneurysm associated with chronic aortic dissection and Marfan syndrome. The postoperative images confirmed patency of the endograft and its branches, and complete exclusion of the aortic false lumen.ConclusionsEndovascular repair is a treatment option in patients with connective tissue disease who are not candidates for open surgery. Long-term follow-up is required to confirm these favorable early outcomes.Copyright © 2016 Elsevier Inc. All rights reserved.

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