Retroperitoneal approach for suprarenal abdominal aortic aneurysm in Marfan syndrome

Abstract

Suprarenal abdominal aortic aneurysms pose a surgical challenge, as it is difficult to reanastomose the renal arteries and to place a cross-clamp to the aortic segment involving the visceral arteries through the diaphragmatic crux. The retroperitoneal approach with a limited thoracoabdominal incision through the ninth intercostal space offers some advantages over the midline transperitoneal approach which we explain by presenting its use in a patient with Marfan syndrome and a true abdominal aortic aneurysm. This technique should be in the armamentarium of aortic surgeons as they have to face with ever-increasingly difficult cases in the endovascular era.