Successful emergency replacement of the ascending aorta and aortic and mitral valves in the Marfan syndrome.

A 37-year-old man with the Marfan syndrome and chronic mitral regurgitation suffered an acute dissecting aneurysm of the ascending aorta with aortic regurgitation. Emergency replacement of the mitral valve, aortic valve, and ascending aorta was carried out, and the patient made an uneventful recovery. He is doing well 18 months after surgery. This is the first reported case of survival from such a procedure in the face of acute dissection with Marfan's syndrome. Indications for elective surgery are discussed and the uncertainties about the prognosis outlined. Continued reporting of the results and follow-up data are necessary for final assessment of the surgical treatment of the cardiovascular manifestations of this disease.