Three-channeled aortic dissection in Marfan syndrome

Among the various types of aortic dissection, three-channeled aortic dissec tion, in which two adjacent false lumens are present, is rarely observed, T he authors surgically treated 20 Marfan syndrome patients with this type of dissection, who accounted for 29.4% of 68 patients with aortic dissection in Marfan syndrome and who were surgically treated in the authors' institut ion prior to July 1999, Patient age ranged from 24 to 51 years (mean of 40 years), The male:female ratio was 13:7, Valved conduit procedure had been p erformed previously in 14 patients, Pain was observed at various times in 1 3 patients, Computed tomography scanning and magnetic resonance imaging wer e useful for preoperative diagnosis, The morphology of the first and second false lumens was Stanford type A + type B in 10 patients and type B + type B in 10 patients, Re-entry of the second false lumen was observed in five patients, The descending aorta was replaced in 13 patients, thoracoabdomina l aortic replacement was performed in five, extra-anatomic bypass in one pa tient and iliac artery-superior mesenteric artery bypass in one, Four patie nts died in hospital, There were three late deaths during a follow-up of 1- 208 months (mean of 51 months), When pain recurs in Marfan patients with ao rtic dissection, three-channeled dissection should be suspected and subsequ ent surgery is required, The incidence of this dissection is high in patien ts with Marfan syndrome, (C) 2000 The International Society for Cardiovascu lar Surgery, Published by Elsevier Science Ltd, All rights reserved.