[Problems and management of surgery on aorta and heart in Marfan syndrome].

From March 1985 to December 1991, 71 patients of aortic root aneurysm and/or aortic insufficiency underwent operative treatment. All the cases are caused by medial cystic necrosis, a predisposing degenerative change in the aorta proven pathologically. 61 Bentall's operation were done, resection of the aneurysm with dacron grafts replacement were performed in 10 cases, including 7 cases of DeBakey type III dissecting aneurysms. The mortality of previous 53 Bentall's operation was 3.77%, but in the last 8 cases (after February 1991), 2 was lost due to uncontrolled infection. So that the total operative mortality was 6.55% (4/61) in 61 Bentall operations. Some catastrophic problems and countermeasures in perioperative period, which met in this series, such as: time of operation, active bleeding and diffused blood oozing, myocardial protection and malignant arrhythmia, selection of valve prosthesis for composite grafts etc, were discussed in this paper.