Redo operation for thoracoaortic aneurysm after entire aortic replacement

Resection of a saccular aneurysm that developed in a remnant of aorta in a patient with Marfan’s syndrome, who previously underwent aortic aneurysmectomy, is described. The intercostal arteries were reconstructed end-to-end using small-caliber interposition grafts to the aortic prosthesis. Preoperative magnetic resonance angiography identified the artery of Adamkiewicz and facilitated its preservation.