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The patient had a history of ascending aortic aneurysm and had formerly undergone replacement of this aortic root and ascending aorta with use of a bioprosthetic valved graft. The kinking was caused by dilation of the native aortic arch. The client underwent successful hemi-arch replacement and repair of the kinked graft. Late complications and reoperation after proximal aortic surgery in clients with Marfan syndrome are unusual, and a high-velocity kept ventricular outf
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