Aortic root surgery in Marfan syndrome

• Verfasst von: Karck, Matthias [VerfasserIn]
• Verfasst von: Kallenbach, Klaus [VerfasserIn]
• Verfasst von: Hagl, Christian Matthias [VerfasserIn]
• Verfasst von: Aichele, Christine [VerfasserIn]
• Verfasst von: Leyh, Rainer Günther [VerfasserIn]
• Verfasst von: Haverich, Axel [VerfasserIn]
• Titel: Aortic root surgery in Marfan syndrome
• Titelzusatz: comparison of aortic valve-sparing reimplantation versus composite grafting
• Verf.angabe: Matthias Karck, MD, Klaus Kallenbach, MD, Christian Hagl, MD, Christine Rhein, MD, Rainer Leyh, MD, Axel Haverich, MD
• E-Jahr: 2004
• Jahr: February 2004
• Umfang: 8 S.
• Fussnoten: Read at the Eighty-third Annual Meeting of The American Association for Thoracic Surgery, Boston, Mass, May 4-7, 2003 ; Gesehen am 30.03.2022
• Titel Quelle: Enthalten in: The journal of thoracic and cardiovascular surgery
• Ort Quelle: Stanford, Calif. : HighWire Press, 1959
• Jahr Quelle: 2004
• Band/Heft Quelle: 127(2004), 2, Seite 391-398
• ISSN Quelle: 1097-685X
• DOI: doi:10.1016/j.jtcvs.2003.07.049
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: 26
• Sach-SW: 35
• K10plus-PPN: 1797029762

Abstract

Objective - The objective of this study was to compare the results of aortic valve-sparing reimplantation and aortic root replacement with mechanical valve conduits in patients with Marfan syndrome undergoing operation for aortic root aneurysms. - Patients and methods - Between March 1979 and April 2002, 119 patients with clinical evidence of Marfan syndrome underwent composite graft replacement with mechanical valve conduits (n = 74) or aortic valve-sparing reimplantation according to David (n = 45). The underlying causes were aortic dissection type A (43 patients) and aneurysms (76 patients). - Results - Patients undergoing aortic valve reimplantation were younger compared with patients undergoing composite grafting (28 vs 35 years, P = .002) and had longer intraoperative aortic crossclamp times (125 vs 78 minutes, P < .0001) and extracorporeal circulation times (162 vs 124 minutes, P < .0001). Early postoperative mortality was 6.8% (n = 5) in patients undergoing composite grafting and 0% in patients undergoing aortic valve reimplantation (P = .15). Mean follow-up was 30 months for patients undergoing aortic valve reimplantation and 114 months for patients undergoing composite grafting. Freedom from reoperation and death after 5 years postoperatively was 92% and 89% in patients undergoing composite grafting and 84% and 96% in patients undergoing aortic valve reimplantation (P = .31; P = .54), respectively. Thromboembolic complications or late postoperative bleeding occurred in 17 patients undergoing composite grafting, and an early postoperative event occurred in 1 patient undergoing aortic valve reimplantation. - Conclusions - The results of aortic valve reimplantation and composite grafting of the aortic valve and ascending aorta with mechanical valve conduits are similar with regard to early and mid-term postoperative mortality and to the incidence of late reoperations in patients with Marfan syndrome. The low risk of thromboembolic or bleeding complications favors aortic valve reimplantation in these patients.