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Aortic Aneurysm in Marfan Syndrome — EECC MCQ

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ModerateAortic DiseaseAortic Aneurysm in Marfan SyndromeEECC

A 55-year-old man with Marfan syndrome is found to have an ascending aortic diameter of 48 mm on echocardiography. He has a bicuspid aortic valve. His uncle died of aortic dissection. Per the 2024 ESC Aortic Disease Guidelines, at what ascending aortic diameter should prophylactic surgical repair be recommended in Marfan syndrome?

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Correct answer: E — 50 mm or above

Per the 2024 ESC Guidelines on Peripheral Arterial and Aortic Diseases, prophylactic surgical repair of the ascending aorta is recommended in Marfan syndrome when the aortic diameter reaches 50 mm or above (Class I). Earlier intervention at 45 mm or above may be considered (Class IIa) with additional risk factors such as family history of dissection, rapid growth, or desire for pregnancy. This patient at 48 mm with a family history falls where surgery at 45 mm or above should be considered.

Reference: ESC (2024): Guidelines for the Management of Peripheral Arterial and Aortic Diseases