Can early aortic root surgery prevent further aortic dissection in Marfan syndrome?

Hideyuki Shimizu, Hirofumi Kasahara, Atsushi Nemoto, Kentaro Yamabe, Toshihiko Ueda, Yohei Yozu

Research output: Contribution to journalReview articlepeer-review

8 Citations (Scopus)

Abstract

We reviewed 50 patients with Marfan syndrome who underwent surgery for aortic root pathologies comprising a root aneurysm without (n = 25; group A) and with (n = 25; group B) dissection. Aortic root repair included Bentall (n = 37) and valve-sparing (n = 13) procedures. Hospital mortality was 4.0%. Twenty-two patients required 36 repeat surgeries on the distal aorta. The main indication for re-intervention was the dilation of the false lumen. In group A, the distal aorta was stable for up to 7 years, but new dissection developed in 5 (33.3%) of the 15 patients who were followed up for >7 years after the root repair. Actuarial survival including operative mortality was 88.1 and 65.0% at 10 and 20 years, respectively; groups A and B did not significantly differ. Rates of freedom from all-cause death, new dissection or repeated aortic surgery were 60.1, 44.5 and 26.0% at 5, 10 and 15 years, respectively. Group A was significantly better than group B. Prophylactic aortic root repair apparently reduces the likelihood of overall adverse events, but it cannot guarantee the prevention of further aortic dissection. A multidisciplinary approach is needed for patients with Marfan syndrome.

Original languageEnglish
Pages (from-to)171-175
Number of pages5
JournalInteractive cardiovascular and thoracic surgery
Volume14
Issue number2
DOIs
Publication statusPublished - 2012 Feb

Keywords

  • Aortic valve
  • Quality of life
  • Reoperation
  • Survival analysis

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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