PMC6378514_01
(a)-(c) Preoperative computed tomography images of the aorta of a woman with Marfan syndrome. The diameter of the sinus of Valsalva was 62 mm (panel b) and that of the thoracoabdominal aorta was 55 mm (panel c). (d) Postoperative computed tomography shows the results of the Bentall operation and total aortic arch replacement with the elephant trunk technique (elephant trunk: 18 mm x 8 cm woven graft).
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Computed tomography (CT) revealed that the diameter of the sinus of Valsalva and thoracoabdominal aorta was 62 and 55 mm, respectively (Figure 1(a)-(c)). The elephant trunk was an 18 mm x 8 cm woven graft (Figure 1(d)).
(a) Angiography shows enhancement of the false lumen. (b) Coils were placed into the aorta through percutaneous femoral access and under local anesthesia. After placing two coils as anchors, the false lumen was filled with eight more coils as embolic material. (c) The proximal false lumen was not completely enhanced, but the vessels perfusing the spinal cord (arrow) were enhanced.
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After inserting two coils as anchors into the false lumen, eight more were inserted as embolic material (IDC, Interlock; Boston scientific, Marlborough, MA, USA; Tornade; Cook Medical, Bloomington, IN, USA) (Figure 2).
(a, b) After 6 months of coil embolization, computed tomography angiography showed a reduction in the thoracic aortic diameter to 60 mm and absence of enhancement of the proximal false lumen. (c) The spinal cord was perfused from the false lumen (arrow).
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The spinal cord still continued to be perfused from the false lumen (Figure 3).