Document Detail


Aortic root surgery in Marfan syndrome.
MedLine Citation:
PMID:  18494230     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: As the shortcomings of the Bentall operation and its variants in the Marfan syndrome have become apparent, the recent cusp-sparing techniques (remodeling or reimplantation) bear promise of better mid-term and long-term outcomes. OBJECTIVE: To examine the results of aortic root surgery in patients with Marfan syndrome. METHODS: During the period March 1994 to September 2007, 220 patients underwent aortic valve-sparing surgery; 20 were Marfan patients (group 1) who were compared with another 20 Marfan patients undergoing composite aortic root replacement (group 2). Fourteen patients had aortic dissection and 26 had thoracic aortic aneurysm. There were 31 males and 9 females with a mean age of 37.9 +/- 13.8 years. In group 1, reimplantation was used in 13 patients, remodeling in 4, and aortic valve repair with sinotubular junction replacement in 3. In group 2, a mechanical valve conduit was used. Mean logistic Euroscore was 12.27 +/- 14.6% for the whole group, five of whom were emergent cases RESULTS: Group 2 had more previous cardiac procedures compared to group 1 (9 vs. 2, P = 0.03) and shorter cross-clamp time (122 +/- 27.1 vs. 153.9 +/- 23.7 minutes, P = 0.0004). Overall mortality was 10%. Early mortality was 10% in group 2 and 5% in group 1 (NS). Mean follow-up time was 25 months for group 2 and 53 months for group 1. Three patients were reoperated; all had undergone the remodeling. Five year freedom from reoperation and death was 86% and 90% in group 2 and 70% and 95% in group 1 (P = 0.6, P = 0.6), respectively. CONCLUSIONS: Late survival of patients with Marfan syndrome was similar in both groups. Root reconstruction tends towards a higher incidence of late reoperations if the remodeling technique is used. We now prefer to use the reimplantation technique.
Authors:
Basheer Sheick-Yousif; Ami Sheinfield; Salis Tager; Probal Ghosh; Sergey Priesman; Aram K Smolinsky; Ehud Raanani
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Israel Medical Association journal : IMAJ     Volume:  10     ISSN:  1565-1088     ISO Abbreviation:  Isr. Med. Assoc. J.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-05-22     Completed Date:  2008-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100930740     Medline TA:  Isr Med Assoc J     Country:  Israel    
Other Details:
Languages:  eng     Pagination:  189-93     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery, Sheba Medical Center, Tel Hashomer, Israel. basheers@zahav.net.il
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MeSH Terms
Descriptor/Qualifier:
Adult
Aneurysm, Dissecting / etiology,  pathology,  surgery*
Aorta, Thoracic*
Aortic Aneurysm / etiology,  pathology,  surgery*
Aortic Valve*
Cardiac Surgical Procedures / methods*
Female
Follow-Up Studies
Humans
Male
Marfan Syndrome / complications*,  mortality,  surgery
Middle Aged
Retrospective Studies
Survival Rate
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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