One day in June 2012, a young man walked up to the cardiac surgery nurses’ station and said, “I’m here for the hospitalization procedure.” The medical staff looked up and was struck by how this patient looked so familiar, was he the twin brother of the young man who had just had heart surgery a week earlier? By the way, the boy’s sibling brother just completed a total aortic replacement surgery here a week ago, and he is currently in the cardiac surgery ward recovering and recuperating. When you look at this, one can’t help but ask, did these two identical brothers get the same disease at the same time? It is very rare for identical twins to have the same cardiovascular disease at the same time. The twin brothers, born in an ordinary rural family, suffered from Marfan’s syndrome, a genetic disease, at the same time, and the brothers underwent aortic replacement surgery at our cardiac surgery department almost simultaneously. It was the first time that such a large operation was performed on twin brothers at the same time in our hospital. The story began last year with the two handsome identical twin brothers from rural Hebei. Their parents told them that there were three boys in the family, and the twin brothers were the most loved by their parents, and they were praised by the villagers for being tall and handsome. But one day in 2011, something happened that made it impossible for the family to be happy anymore: the twin brother was diagnosed with an acute clogged aneurysm that required emergency surgery. The parents took their youngest son to their beloved medical sanctuary, —- Peking Union Medical College Hospital. When they heard that their children had hereditary Marfan’s syndrome, a name that was both unfamiliar and terrifying, the two old men were completely psychologically broken. The brother underwent successful interventional stent implantation in the descending aorta at the cardiac surgery department of the Peking Union Medical College Hospital. The doctor’s remark made the two old people who had just put their hearts down put their hearts in their throats again, “Marfan’s syndrome is a familial disorder that usually occurs in a family in an epidemic or multiple occurrence manner”. Parents dare not think further …… disaster befell the family again in March this year, the twin brother also because of acute descending aortic coarctation, because of the involvement of the total descending aorta in the Union Hospital Cardiac Surgery Department underwent direct vision total descending aortic replacement surgery, the operation also reconstructed the abdominal branch vessels respectively, the patient successfully passed the bleeding, paraplegia and other dangers The patient successfully survived the risks of bleeding and paraplegia. When the twin brothers were discharged from the hospital, Director Miao Qi instructed that since the Marfan’s syndrome suffered by the twin brothers had involved multiple parts of the aorta at the same time, resulting in severe dilatation of the arteries, entrapment and severe regurgitation of the heart valves, other parts of the aorta should be replaced as soon as possible, including the aortic root, ascending aorta, aortic arch replacement and coronary artery transplantation, to avoid catastrophic vascular rupture or heart failure. So in June of this year, the twin brother returned to the cardiac surgery department of the Union Hospital for a second operation, this time to completely remove the diseased artery, and because the operation involved both the heart valves and the head vessels, it was necessary to stop the blood supply to the heart and the whole body at the same time for 40-50 minutes during the operation! Time was of the essence, and the doctors once again experienced the feeling of life and death: 220 minutes of uninterrupted vascular anastomosis to re-establish the connection between the heart and the artificial vessel, coronary artery grafting to restore the blood supply to the heart, cerebral revascularization to ensure the blood supply to the brain, and finally an endovascular stent as a bridge to connect the aortic arch to the phase I descending aortic artificial vessel. The heart resumed its rhythmic beating, the EEG resumed its regular waveform, and the brother’s life was saved. The twin brother who accompanied the brother to the surgery was found to have a coarctation of the proximal and distal aorta with severe arterial dilatation during the review of the stent implanted six months ago. The younger brother’s vascular lesion was more serious than the older brother’s, which undoubtedly cast a shadow over the family again, but they were still fortunate that early diagnosis gave the younger brother the opportunity to have surgery. Early surgery to replace the diseased aorta was the only treatment, which led to the scene at the beginning of this article. The twin brother was hospitalized again, and on the seventh day after his brother’s surgery, he underwent an ascending aorta and aortic arch replacement, along with an aortic valve replacement and filling artery graft and distal elephant trunk stenting. Once again, the surgical time to stop circulation, almost identical to that of the brother, tested the nerves of the surgeons. Marfan’s?Syndrome, a congenital hereditary connective tissue disorder, is autosomal dominant and has a family history. The incidence is about 0.04 to 0.1 per 1000. The main manifestations are skeletal, ocular and cardiovascular involvement. The disease is associated with congenital cardiovascular malformations in approximately 80% of patients. Progressive dilatation of the aorta, incomplete closure of the aortic valve, and aortic sinus aneurysm due to cystic necrosis of the middle layer of the aorta are common. Watching her twin sons undergo surgery at the same time and achieve success, the mother could not help but shed tears and said emotionally after the surgery, “It was the entire medical staff of the cardiac surgery department of Concordia Hospital that gave the brothers a second new life once again.” After the surgery, both brothers were discharged from the hospital 1 week after the surgery under the careful care of the medical and nursing staff. The incidence of twins, calculated using the Hellin formula, is one in 89 pregnancies, which is rare. The incidence of Marfan’s syndrome is 0.04 to 0.1 per 1,000, so the chance of twins having the same disease is even smaller, and it is even rarer for twin brothers to have cardiovascular disease at the same time. After the successful surgery, the brothers will lead a normal life as healthy people. When they were discharged from the hospital, their mother choked up again and again and said that in the future, when the brothers marry their daughter-in-law, they must invite all the medical and nursing staff of the cardiac surgery department to their wedding to witness the happy life of the twin brothers.