| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Eur J Cardiothorac Surg 2000;17:415-419
© 2000 Elsevier Science NL
a Division of Cardiovascular Surgery, Toronto General Hospital and University of Toronto, Toronto, Ontario, Canada
b Division of Cardiology, Toronto General Hospital and University of Toronto, Toronto, Ontario, Canada
Corresponding author. 200 Elizabeth St., 12EN219, Toronto, Ontario, M5G 2C4, Canada. Tel.: +1-416-340-4789; fax: +1-416-340-4020
e-mail: tirone.david{at}uhn.on.ca
Objective: To evaluate the results of two operations, aortic valve-sparing and aortic root replacement, in patients with aortic root aneurysm and the Marfan syndrome. Methods: A retrospective review of 78 consecutive patients with aortic root aneurysm and the Marfan syndrome according to the Gent criteria indicated that 42 patients with normal aortic cusps had an aortic valve-sparing operation, and 36 patients had aortic root replacement (mechanical valve in 25 patients and biological valve in 11). The mean age was similar in both groups, but patients who had aortic root replacement had larger aneurysms, higher grade aortic insufficiency, worse left ventricular function and more cardiac co-morbidity than patients who had aortic valve-sparing operations. The mean follow-up was 41±35 months for patients who had aortic valve-sparing, and 65±50 months for those who had aortic root replacement. Results: Kaplan–Meyer estimates of survival at 5 years was 100% for patients who had aortic valve-sparing, and 88±6% for those who had aortic root replacement (P=0.04). Five patients who had aortic root replacement required seven aortic root re-replacements: three for endocarditis and four for valve failure (biological valves). There have been no reoperations in patients who had aortic valve-sparing operations and annual Doppler echocardiography revealed mild or no aortic insufficiency in 39 patients and moderate aortic insufficiency in three. Conclusions: These data suggest that aortic valve-sparing operations are safe in patients with the Marfan syndrome and may provide better clinical outcomes than aortic root replacement. Since the size of the aneurysm often determines the feasibility of a valve-sparing procedure, we now recommend surgery when the diameter of the aortic root reaches 50 mm in patients with the Marfan syndrome who have echocardiographically normal aortic valve cusps.
Key Words: Aortic root aneurysm • Marfan syndrome
This article has been cited by other articles:
|
|
 |
|
  M. S. Kalkat, I. Rahman, K. Kotidis, B. Davies, and R. S. Bonser Presentation and outcome of Marfan's syndrome patients with dissection and thoraco-abdominal aortic aneurysm Eur. J. Cardiothorac. Surg., August 1, 2007; 32(2): 250 - 254. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. C. Miller Valve-Sparing Aortic Root Replacement: Current State of the Art and Where Are We Headed? Ann. Thorac. Surg., February 1, 2007; 83(2): S736 - S739. [Full Text] [PDF]
|
|
|
|
|
|
J. M. Albes, U. A. Stock, and M. Hartrumpf Restitution of the Aortic Valve: What is New, What is Proven, and What is Obsolete? Ann. Thorac. Surg., October 1, 2005; 80(4): 1540 - 1549. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. J. Meijboom, B. E. Westerhof, G. J. Nollen, J. A.E. Spaan, B. A.J.M. de Mol, M. J.H.M. Jacobs, and B. J.M. Mulder Beta-blocking therapy in patients with the Marfan syndrome and entire aortic replacement Eur. J. Cardiothorac. Surg., November 1, 2004; 26(5): 901 - 906. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Carrel, L. Beyeler, A. Schnyder, P. Zurmuhle, P. Berdat, J. Schmidli, and F. S. Eckstein Reoperations and late adverse outcome in Marfan patients following cardiovascular surgery Eur. J. Cardiothorac. Surg., May 1, 2004; 25(5): 671 - 675. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Karck, K. Kallenbach, C. Hagl, C. Rhein, R. Leyh, and A. Haverich Aortic root surgery in Marfan syndrome: Comparison of aortic valve-sparing reimplantation versus composite grafting J. Thorac. Cardiovasc. Surg., February 1, 2004; 127(2): 391 - 398. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Kirali, V. Erentug, M. B Rabus, A. Izgi, N. U Bozbuga, K. Erkanli, E. Akinci, and C. Yakut Extensive Aortic Surgery in Marfan Syndrome: 16-Year Experience Asian Cardiovasc Thorac Ann, December 1, 2003; 11(4): 337 - 341. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. G. Svensson Sizing for modified david's reimplantation procedure Ann. Thorac. Surg., November 1, 2003; 76(5): 1751 - 1753. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. G. Leyh, K. Kallenbach, M. Karck, C. Hagl, S. Fischer, and A. Haverich Impact of Preoperative Aortic Root Diameter on Long-Term Aortic Valve Function After Valve Sparing Aortic Root Reimplantation Circulation, September 9, 2003; 108(90101): II-285 - 290. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Carrel, P. Berdat, M. Pavlovic, S. Sukhanov, L. Englberger, and J.-P. Pfammatter Surgery of the dilated aortic root and ascending aorta in pediatric patients: techniques and results Eur. J. Cardiothorac. Surg., August 1, 2003; 24(2): 249 - 254. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. C. Miller Valve-sparing aortic root replacement in patients with the Marfan syndrome J. Thorac. Cardiovasc. Surg., April 1, 2003; 125(4): 773 - 778. [Full Text] [PDF]
|
|
|
|
|
|
N. C. de Oliveira, T. E. David, J. Ivanov, S. Armstrong, M. J. Eriksson, H. Rakowski, and G. Webb Results of surgery for aortic root aneurysm in patients with Marfan syndrome J. Thorac. Cardiovasc. Surg., April 1, 2003; 125(4): 789 - 796. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. E. David Aortic Valve Repair and Aortic Valve-Sparing Operations Card. Surg. Adult, January 1, 2003; 2(2003): 811 - 824. [Full Text]
|
|
|
|
|
|
K. Kallenbach, M. Karck, R. G. Leyh, C. Hagl, T. Walles, W. Harringer, and A. Haverich Valve-sparing aortic root reconstruction in patients with significant aortic insufficiency Ann. Thorac. Surg., November 1, 2002; 74(5): S1765 - 1768. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K.-H. Kim, C. Lee, and H. Ahn Successful treatment in a patient with Takayasu's arteritis and Marfan syndrome Ann. Thorac. Surg., September 1, 2002; 74(3): 908 - 910. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. De Paulis, G. M. De Matteis, P. Nardi, R. Scaffa, D. F. Colella, C. Bassano, F. Tomai, and L. Chiariello One-year appraisal of a new aortic root conduit with sinuses of Valsalva J. Thorac. Cardiovasc. Surg., January 1, 2002; 123(1): 33 - 39. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. E. David, S. Armstrong, J. Ivanov, C. M. Feindel, A. Omran, and G. Webb Results of aortic valve-sparing operations J. Thorac. Cardiovasc. Surg., July 1, 2001; 122(1): 39 - 46. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Bassano, G. M. De Matteis, P. Nardi, M. M. Buratta, J. Zeitani, R. De Paulis, and L. Chiariello Mid-term follow-up of aortic root remodelling compared to Bentall operation Eur. J. Cardiothorac. Surg., May 1, 2001; 19(5): 601 - 605. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
