Early outcomes of patients with Marfan syndrome and acute aortic type A dissection

• Verfasst von: Farag, Mina [VerfasserIn]
• Verfasst von: Büsch, Christopher [VerfasserIn]
• Verfasst von: Rylski, Bartosz [VerfasserIn]
• Verfasst von: Pöling, Jochen [VerfasserIn]
• Verfasst von: Dohle, Daniel S. [VerfasserIn]
• Verfasst von: Sarvanakis, Konstantinos [VerfasserIn]
• Verfasst von: Hagl, Christian [VerfasserIn]
• Verfasst von: Krüger, Tobias [VerfasserIn]
• Verfasst von: Detter, Christian [VerfasserIn]
• Verfasst von: Holubec, Tomas [VerfasserIn]
• Verfasst von: Borger, Michael A. [VerfasserIn]
• Verfasst von: Böning, Andreas [VerfasserIn]
• Verfasst von: Karck, Matthias [VerfasserIn]
• Verfasst von: Arif, Rawa [VerfasserIn]
• Titel: Early outcomes of patients with Marfan syndrome and acute aortic type A dissection
• Verf.angabe: Mina Farag, Christopher Büsch, Bartosz Rylski, Jochen Pöling, Daniel S. Dohle, Konstantinos Sarvanakis, Christian Hagl, Tobias Krüger, Christian Detter, Tomas Holubec, Michael A. Borger, Andreas Böning, Matthias Karck, and Rawa Arif, German Registry for Acute Aortic Dissection Type A Working Group of the German Society of Thoracic, Cardiac and Vascular Surgery
• E-Jahr: 2023
• Jahr: July 2023
• Umfang: 18 S.
• Illustrationen: Illustrationen
• Fussnoten: Online verfügbar: 21. Juli 2021, Artikelversion: 13. Juni 2023 ; Gesehen am 07.08.2023
• Titel Quelle: Enthalten in: The journal of thoracic and cardiovascular surgery
• Ort Quelle: Amsterdam : Elsevier, 1959
• Jahr Quelle: 2023
• Band/Heft Quelle: 166(2023), 1 vom: Juli, Seite 25-34.e8
• ISSN Quelle: 1097-685X
• DOI: doi:10.1016/j.jtcvs.2021.07.024
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: aortic arch
• Sach-SW: aortic dissection
• Sach-SW: aortic root
• Sach-SW: Marfan syndrome
• K10plus-PPN: 1854452673

Abstract

Background - Acute aortic Stanford type A dissection remains a frequent and life-limiting event for patients with Marfan syndrome. Outcome results in this high-risk group are limited. - Methods - The German Registry for Acute Aortic Dissection Type A collected the data of 56 centers between July 2006 and June 2015. Of 3385 patients undergoing operations for acute aortic Stanford type A dissection, 117 (3.5%) were diagnosed with Marfan syndrome. We performed a propensity score match comparing patients with Marfan syndrome with patients without Marfan syndrome in a 1:2 fashion. - Results - Patients with Marfan syndrome were significantly younger (42.9 vs 62.2 years; P < .001), predominantly male (76.9% vs 62.9%; P = .002), and less catecholamine dependent (9.4% vs 20.3%; P = .002) compared with the unmatched cohort. They presented with aortic regurgitation (41.6% vs 23.0%; P < .001) and involvement of the supra-aortic vessels (50.4% vs 39.5%; P = .017) more often. Propensity matching revealed 82 patients with Marfan syndrome (21 female) with no significant differences in baseline characteristics compared with patients without Marfan syndrome (n = 159, 36 female; P = .607). Although root preservation was more frequent in patients with Marfan syndrome, procedure types did not differ significantly (18.3% vs 10.7%; P = .256). Aortic arch surgery was performed more frequently in matched patients (87.5% vs 97.8%; P = .014). Thirty-day mortality did not differ between patients with and without Marfan syndrome (19.5% vs 20.1%; P = .910). Multivariate regression showed no influence of Marfan syndrome on 30-day mortality (odds ratio, 0.928; 95% confidence interval, 0.346-2.332; P = .876). - Conclusions - Marfan syndrome does not adversely affect 30-day outcomes after surgical repair for acute aortic Stanford type A dissection compared with a matched cohort. Long-term outcome analysis is needed to account for the influence of further downstream interventions.