Results of surgery for aortic root aneurysm in patients with Marfan syndrome
Autor: | Harry Rakowski, Tirone E. David, Nilto Carias de Oliveira, Maria J. Eriksson, Gary D. Webb, Joan Ivanov, Susan Armstrong |
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Rok vydání: | 2003 |
Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Valve-sparing aortic root replacement Aortic valve Marfan syndrome medicine.medical_specialty Adolescent Marfan Syndrome Aortic aneurysm Postoperative Complications Aneurysm medicine.artery medicine Humans Cardiac skeleton Child Aged Ultrasonography Postoperative Care Aorta Aortic Aneurysm Thoracic integumentary system business.industry medicine.disease Surgery medicine.anatomical_structure Cardiothoracic surgery cardiovascular system Female Cardiology and Cardiovascular Medicine business |
Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 125:789-796 |
ISSN: | 0022-5223 |
Popis: | Objectives: This study was undertaken to examine the long-term results of surgery for aortic root aneurysm in patients with Marfan syndrome. Methods: Forty-four patients underwent aortic root replacement and 61 underwent aortic valve-sparing operations for aortic root aneurysm. Patients who underwent aortic root replacement had more severe symptoms, worse left ventricular function, more severe aortic insufficiency, and larger aortic root aneurysms than did patients who had aortic valve-sparing operations. Two types of valve-sparing operations were performed: reimplantation of the aortic valve in 39 patients and remodeling of the aortic root in 22 patients. Echocardiography was performed annually during follow-up. The mean follow-ups were 75 ± 54 months for the aortic root replacement group and 49 ± 38 months for the aortic valve-sparing group. Results: There were 1 early death and 7 late deaths; 6 deaths were in the aortic root replacement group and 2 were in the aortic valve-sparing group. Survivals at 10 years were 87% in the aortic root replacement group and 96% in the aortic valve-sparing group ( P =.3). Freedoms from reoperation at 10 years were 75% in the root replacement group and 100% in the valve-sparing group ( P =.1). Freedoms from valve-related mortality and morbidity were 65% after root replacement and 100% after valve-sparing operation ( P =.02). Freedom from aortic insufficiency greater than 2+ after aortic valve-sparing operations was 75% at 10 years and was similar for both types of valve-sparing operations; however, the diameters of the aortic annulus and neoaortic sinuses increased only after the remodeling procedure. Conclusions: This study suggests that aortic valve-sparing operations provide similar survival but lower rates of valve-related complications than aortic root replacement for patients with Marfan syndrome. Reimplantation of the aortic valve may be more appropriate than remodeling of the aortic root to prevent dilation of the aortic annulus, and for this reason we now use only this technique to treat patients with Marfan syndrome. J Thorac Cardiovasc Surg 2003;125:789-96 |
Databáze: | OpenAIRE |
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