Long-Term Results of Aortic Root Surgery in Marfan Syndrome Patients: A Single-Center Experience.
J Heart Valve Dis
; 26(4): 397-404, 2017 07.
Article
em En
| MEDLINE
| ID: mdl-29302938
ABSTRACT
BACKGROUND AND AIM OF THE STUDY The study aim was to compare long-term results of Marfan syndrome (MFS) patients affected by aortic root disease undergoing aortic root replacement with the Bentall or David operation. METHODS:
Since 1994, a total of 59 patients has been followed at the authors' Marfan Center, having undergone either a Bentall operation (Bentall group, n = 30) or a David operation (David group, n = 29).RESULTS:
No operative mortality was recorded. After 20 years (mean follow up 97 ± 82 months; range 1 to 369 months) no prosthesis-related major bleeding or thromboembolic events had been observed; the 20-year survival was 94 ± 6% in the Bentall group, and 100% in the David group (p = 0.32). Freedom from reintervention for aortic valve dysfunction was 100% in the Bentall group, and 75 ± 13% in the David group (p = 0.04). This inter-group difference became relevant after the first eight-year period of follow-up, and was mainly associated with a particular familiar genetic phenotype involving three out of four reoperated patients. Freedom from all-cause death, myocardial infarction, stroke, prosthetic valve-related complications, and reintervention on any aortic segment was 69 ± 12% in the Bentall group, and 67 ± 14% in the David group (p = 0.33).CONCLUSIONS:
The Bentall and David operations are both associated with satisfactory long-term results in MFS patients. The low rate of valve prosthesis-related complications suggested that the Bentall operation would continue to be a standard surgical treatment. The reimplantation technique, adopted for less-dilated aortas, provides satisfactory freedom from reoperation. Careful attention should be paid to the reimplantation technique in patients affected by a serious familiar genetic phenotype.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Aneurisma Aórtico
/
Insuficiência da Valva Aórtica
/
Implante de Prótese de Valva Cardíaca
/
Implante de Prótese Vascular
/
Síndrome de Marfan
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
País/Região como assunto:
Europa
Idioma:
En
Revista:
J Heart Valve Dis
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2017
Tipo de documento:
Article