Proximal stenting to resolve malperfusion before arch repair of a Marfan Type A dissection

Malperfusion has been reported as one of the strongest predictors of morbidity and mortality during arch repair in the setting of a Type A aortic dissection. Interventions to restore perfusion can present additional challenges, especially in the setting of patients with connective tissue disorders and anticipation of an ultimate major aortic reconstruction. We report on a 23-year-old patient with Marfan syndrome, who presented with prior hemiarch repair and new Type A dissection with malperfusion of the viscera and lower body. The use of aortic stenting to restore perfusion allowed staging of his redo sternotomy and ultimately a hybrid thoracoabdominal repair.