Document Detail


Stent grafting of dissected descending aorta in patients with Marfan's syndrome: mid-term results.
MedLine Citation:
PMID:  19463383     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study sought to assess the safety and the effectiveness of endovascular stent grafting of chronic aortic dissection (AD) in Marfan patients.
BACKGROUND: The management of chronic AD of the descending thoracic aorta (DTA) is challenging. This is especially true in Marfan patients, who tend to exhibit poor short- and long-term results after conventional surgery.
METHODS: Fifteen patients with Marfan's syndrome and chronic AD of the DTA were identified among the 457 patients of the European Talent Registry. All patients underwent endovascular treatment.
RESULTS: No major adverse event was encountered during the procedure. Five patients experienced a primary endoleak (type 1, n = 4; type 2, n = 1). Three of them died, and 1 underwent successful conversion to open surgery. Five other patients experienced secondary endoleak (type 1, n = 4; type 3, n = 1). Four of them underwent successful conversion to either open or endovascular reintervention. Two other patients underwent successful conversion to open repair because of secondary aortic enlargement below the stent graft. After a mean follow-up of 2.1 +/- 1.4 years, 12 patients are alive. Of these 12, conversion to open repair was successfully performed in 5 patients. In the remaining 7 patients, complete thrombosis of the false lumen was achieved in 6 patients, with partial thrombosis in 1 patient.
CONCLUSIONS: Endovascular stent grafting of the dissected DTA is feasible in selected Marfan patients with low mortality and morbidity rates. Nevertheless, the rate of primary and secondary endoleak is high. Close imaging surveillance is crucial to detect secondary aortic complications and to assess long-term results.
Authors:
Bertrand Marcheix; Hervé Rousseau; Vanina Bongard; Robin H Heijmen; Christoph A Nienaber; Marek Ehrlich; Philippe Amabile; Jean-Paul Beregi; Rossela Fattori
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  1     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2009-05-25     Completed Date:  2009-06-11     Revised Date:  2014-09-05    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  673-80     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aneurysm, Dissecting / etiology,  mortality,  radiography,  surgery*
Aortic Aneurysm, Thoracic / etiology,  mortality,  radiography,  surgery*
Aortography / methods
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / adverse effects,  instrumentation*,  mortality
Chronic Disease
Europe
Feasibility Studies
Female
Humans
Male
Marfan Syndrome / complications*,  mortality,  radiography,  surgery
Middle Aged
Prosthesis Failure
Registries
Reoperation
Retrospective Studies
Stents*
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Young Adult

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


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