Complex Dissected Subclavian Artery Aneurysm Repair for a Patient With Marfan Syndrome

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BACKGROUND: Marfan syndrome is a connective tissue disorder associated with progressive vascular complications, particularly aortic and great vessel aneurysms, which present major management challenges. CASE SUMMARY: A 56-year-old woman with a history of 4 prior aortic operations underwent repair of large coronary button aneurysms. Her recovery was uneventful, but 2 months later she developed a right subclavian artery dissection with rapid aneurysmal degeneration. After a period of brief surveillance, a multidisciplinary team performed a complex repair with debranching and bypass of the right common carotid and subclavian arteries along with vertebral artery transposition. DISCUSSION: MFS patients may experience rapid and unpredictable vascular progression. Vigilant follow-up, individualized surgical planning, and multidisciplinary collaboration are essential for optimal outcomes. TAKE-HOME MESSAGE: Marfan patients require close surveillance and proactive, team-based strategies to address evolving vascular complications.

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