Bilateral axillary artery aneurysms after Bentall procedure in Marfan syndrome

Abstract

A man with Marfan syndrome underwent a Bentall procedure for annuloaortic ectasia and severe aortic regurgitation at 43 years of age. Twenty-eight years after the Bentall procedure, he developed bilateral axillary artery aneurysms (length × diameter: right: 80 × 39 mm; left: 103 × 45 mm). Aneurysmectomy and reconstruction of the axillary artery were performed using an artificial vascular graft. Histological examination revealed cystic medial necrosis. The postoperative course was uneventful, but long-term follow-up is necessary.

Surgical Treatment of a Left Axillary Arterial Aneurysm with Marfan Syndrome by Combining Two Skin Incisions

“… 3 ) Furthermore, a bilateral axillary aneurysm with Marfan syndrome is even rarer, and few studies have reported such cases. 4 , 5 ) Notably, our case did not exhibit an aneurysmal change in the right axillary artery, and the size of the artery was standard.…”

Large-Sized Bilateral Atherosclerotic Axillary Artery Aneurysms: A Case Report

“…In the literature, axillary artery aneurysms are mostly unilateral. Bilateral axillary artery aneurysms were only reported in two Marfan syndrome patients [ 7 8 ]. However, thrombus in the aneurysmal lumen, which are used for differential diagnosis of atherosclerotic aneurysms, were not reported in either of the Marfan syndrome patients [ 3 ].…”

“…The largest aneurysm treated by an endovascular method was 3 × 5 cm in size. Surgery is preferred for larger and tortuous aneurysms [ 7 ]. We also opted for surgery in this case because the aneurysms were very large and tortuous.…”

Mutation in Genes FBN1, AKT1, and LMNA: Marfan Syndrome, Proteus Syndrome, and Progeria Share Common Systemic Involvement

“…52 Myocardial infarction and bacterial endocarditis are some cardiac causes of death. 54 In vascular system, there can be many types of defects in arterial wall including calcification. Rarely it shows axillary artery aneurysm.…”

“…49 MFS and Proteus syndrome also share ventricular hypertrophy and dysfunction, 50,51,65 systolic and diastolic abnormality, 51,66 cardiac murmur, angina pectoris, congestive cardiac failure and myocardial infarction in common. 52,54,66 On the other hand, Proteus syndrome and Progeria both can cause thickening of myocardial septum, 59,65 cardiomyopathy, myocardial fibrosis and mass, 59,66 and abnormality in vascular endothelium. 33,63,67 Some other regular features of cardio-vascular system which are common in all these three mutations are discussed in the Table 2.…”