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Long-Term Results of Aortic Root Surgery in Marfan Syndrome Patients: A Single-Center Experience.
Nicolo, Francesco; Romeo, Francesco; Lio, Antonio; Bovio, Emanuele; Scafuri, Antonio; Bassano, Carlo; Polisca, Patrizio; Pellegrino, Antonio; Nardi, Paolo; Chiariello, Luigi; Ruvolo, Giovanni.
Afiliação
  • Nicolo F; Cardiac Surgery Unit and Marfan Center, Tor Vergata University Policlinic, Rome, Italy. Electronic correspondence: nicolo_francy84@hotmail.it.
  • Romeo F; Department of Cardiovascular Disease, Tor Vergata University Policlinic, Rome, Italy.
  • Lio A; Cardiac Surgery Unit and Marfan Center, Tor Vergata University Policlinic, Rome, Italy.
  • Bovio E; Cardiac Surgery Unit and Marfan Center, Tor Vergata University Policlinic, Rome, Italy.
  • Scafuri A; Cardiac Surgery Unit and Marfan Center, Tor Vergata University Policlinic, Rome, Italy.
  • Bassano C; Cardiac Surgery Unit and Marfan Center, Tor Vergata University Policlinic, Rome, Italy.
  • Polisca P; Cardiac Surgery Unit and Marfan Center, Tor Vergata University Policlinic, Rome, Italy.
  • Pellegrino A; Cardiac Surgery Unit and Marfan Center, Tor Vergata University Policlinic, Rome, Italy.
  • Nardi P; Cardiac Surgery Unit and Marfan Center, Tor Vergata University Policlinic, Rome, Italy.
  • Chiariello L; Cardiac Surgery Unit, Clinica Mediterranea, Naples, Italy.
  • Ruvolo G; Cardiac Surgery Unit and Marfan Center, Tor Vergata University Policlinic, Rome, Italy.
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.
Assuntos
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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
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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
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