Document Detail


Aortic valve-sparing operation in Marfan syndrome: what do we know after a decade?
MedLine Citation:
PMID:  17257923     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We assessed the outcome in patients with Marfan syndrome operated on exclusively with the aortic valve-sparing reimplantation technique for aortic root aneurysms during more than a decade. METHODS: Between July 1993 and April 2005, the aortic valve-sparing reimplantation technique (David I) was used in 325 patients. In 59 patients with clinical evidence of Marfan syndrome, procedures were done for aortic root aneurysm (n = 55) or aortic dissection type A (n = 4). Their mean age was 30 +/- 12 years (range, 9 to 62 years), and 37 (63%) were male. Additional procedures were arch replacement in 4 patients, coronary artery bypass grafting in 1, mitral valve surgery in 9, and closure of atrial septal defect in 3. Mean follow-up was 54 +/- 37 months (range, 0 to 139 months). RESULTS: No patient died during the first 30 days postoperatively. Mean bypass time was 163 +/- 34 minutes (range, 99 to 248 minutes), and mean aortic cross clamp time was 126 +/- 28 minutes (range, 78 to 202 minutes). Four patients (6.8%) required rethoracotomy for postoperative bleeding. Five late deaths (8.5%) occurred during follow-up. Reoperation of the reconstructed valve was required in 7 patients. Freedom from reoperation was 88% +/- 5% at 5 years and 80% +/- 9% at 10 years. Mean grade of aortic insufficiency was 1.81 preoperatively compared with 0.20 early postoperatively (p < 0.001). At last investigation, the mean grade of aortic insufficiency increased slightly to 0.22 (p = 0.16). Anticoagulation was not required in 67% of patients. One thromboembolic complication and four instances of minor bleeding were documented. All patients were in New York Heart Association functional class I (86%) or II at last contact. CONCLUSIONS: Excellent early outcome, favorable long-term results, and acceptable durability of the reimplanted valve should encourage use of this technique in patients with Marfan syndrome.
Authors:
Klaus Kallenbach; Hassina Baraki; Nawid Khaladj; Hiroyuki Kamiya; Christian Hagl; Axel Haverich; Matthias Karck
Related Documents :
18290883 - Mid-term outcome with surgery for type b aortic dissections: a single center experience.
10215223 - Is direct closure dangerous for treatment of doubly committed subarterial ventricular s...
21237723 - Five-year follow-up after biliopancreatic diversion with duodenal switch.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  83     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-29     Completed Date:  2007-03-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  S764-8; discussion S785-90     Citation Subset:  AIM; IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany. klaus.kallenbach@med.uni-heidelberg.de
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aneurysm, Dissecting / complications,  etiology,  surgery*
Anticoagulants / therapeutic use
Aortic Aneurysm / complications,  etiology,  surgery*
Aortic Valve / surgery*
Aortic Valve Insufficiency / etiology,  physiopathology
Child
Female
Follow-Up Studies
Hemorrhage / etiology,  surgery
Humans
Male
Marfan Syndrome / complications*
Middle Aged
Reoperation
Replantation*
Thoracotomy
Thromboembolism / etiology
Vascular Surgical Procedures* / adverse effects,  mortality
Chemical
Reg. No./Substance:
0/Anticoagulants

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


Previous Document:  Early surgical experience with Loeys-Dietz: a new syndrome of aggressive thoracic aortic aneurysm di...
Next Document:  Reimplantation valve-sparing aortic root replacement in Marfan syndrome using the Valsalva conduit: ...