| Aortic valve-sparing operation in Marfan syndrome: what do we know after a decade? | |
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MedLine Citation:
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PMID: 17257923 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Klaus Kallenbach; Hassina Baraki; Nawid Khaladj; Hiroyuki Kamiya; Christian Hagl; Axel Haverich; Matthias Karck |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 83 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2007 Feb |
Date Detail:
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Created Date: 2007-01-29 Completed Date: 2007-03-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: Netherlands |
Other Details:
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Languages: eng Pagination: S764-8; discussion S785-90 Citation Subset: AIM; IM |
Affiliation:
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Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany. klaus.kallenbach@med.uni-heidelberg.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Anticoagulants |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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