| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 2003;125:789-796
© 2003 The American Association for Thoracic Surgery
Surgery for Acquired Cardiovascular Disease |
From the Divisions of Cardiovascular Surgery and Cardiology of Toronto General Hospital and University of Toronto, Toronto, Ontario, Canada.
Read at the Eighty-second Annual Meeting of The American Association for Thoracic Surgery, Washington, DC, May 5-8, 2002.
Received for publication May 5, 2002. Revisions requested Aug 1, 2002; revisions received Aug 9, 2002. Accepted for publication Aug 15, 2002. Address for reprints: Tirone E. David, MD, 200 Elizabeth St, 13EN-219, Toronto, Ontario, Canada M5G 2C4 (E-mail: tirone.david{at}uhn.on.ca).
Objectives: This study was undertaken to examine the long-term results of surgery for aortic root aneurysm in patients with Marfan syndrome.
Methods: Forty-four patients underwent aortic root replacement and 61 underwent aortic valve-sparing operations for aortic root aneurysm. Patients who underwent aortic root replacement had more severe symptoms, worse left ventricular function, more severe aortic insufficiency, and larger aortic root aneurysms than did patients who had aortic valve-sparing operations. Two types of valve-sparing operations were performed: reimplantation of the aortic valve in 39 patients and remodeling of the aortic root in 22 patients. Echocardiography was performed annually during follow-up. The mean follow-ups were 75 ± 54 months for the aortic root replacement group and 49 ± 38 months for the aortic valve-sparing group.
Results: There were 1 early death and 7 late deaths; 6 deaths were in the aortic root replacement group and 2 were in the aortic valve-sparing group. Survivals at 10 years were 87% in the aortic root replacement group and 96% in the aortic valve-sparing group (P = .3). Freedoms from reoperation at 10 years were 75% in the root replacement group and 100% in the valve-sparing group (P = .1). Freedoms from valve-related mortality and morbidity were 65% after root replacement and 100% after valve-sparing operation (P = .02). Freedom from aortic insufficiency greater than 2+ after aortic valve-sparing operations was 75% at 10 years and was similar for both types of valve-sparing operations; however, the diameters of the aortic annulus and neoaortic sinuses increased only after the remodeling procedure.
Conclusions: This study suggests that aortic valve-sparing operations provide similar survival but lower rates of valve-related complications than aortic root replacement for patients with Marfan syndrome. Reimplantation of the aortic valve may be more appropriate than remodeling of the aortic root to prevent dilation of the aortic annulus, and for this reason we now use only this technique to treat patients with Marfan syndrome.
Related Article
J. Thorac. Cardiovasc. Surg. 2003 125: 773-778.
This article has been cited by other articles:
|
|
 |
|
  M. Ono, H. Goerler, D. Boethig, M. Westhoff-Bleck, and T. Breymann Current surgical management of ascending aortic aneurysm in children and young adults. Ann. Thorac. Surg., November 1, 2009; 88(5): 1527 - 1533. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. Sheikh and T. E. David Aortic valve-sparing operations: dealing with the coronary artery that is too close to the aortic annulus. Ann. Thorac. Surg., September 1, 2009; 88(3): 1026 - 1028. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. S. Jeong, K.-H. Kim, and H. Ahn Long-term results of the leaflet extension technique in aortic regurgitation: thirteen years of experience in a single center. Ann. Thorac. Surg., July 1, 2009; 88(1): 83 - 89. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. D. Everitt, N. Pinto, J. A. Hawkins, M. B. Mitchell, P. C. Kouretas, and A. T. Yetman Cardiovascular surgery in children with Marfan syndrome or Loeys-Dietz syndrome. J. Thorac. Cardiovasc. Surg., June 1, 2009; 137(6): 1327 - 1333. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. V. Volguina, D. C. Miller, S. A. LeMaire, L. C. Palmero, X. L. Wang, H. M. Connolly, T. M. Sundt III, J. E. Bavaria, H. C. Dietz, D. M. Milewicz, et al. Valve-sparing and valve-replacing techniques for aortic root replacement in patients with Marfan syndrome: Analysis of early outcome. J. Thorac. Cardiovasc. Surg., May 1, 2009; 137(5): 1124 - 1132. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Formigari, G. Michielon, M. C. Digilio, G. Piacentini, A. Carotti, A. Giardini, R. M. Di Donato, and B. Marino Genetic syndromes and congenital heart defects: how is surgical management affected? Eur. J. Cardiothorac. Surg., April 1, 2009; 35(4): 606 - 614. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Hess Jr, P. K. Harman, C. T. Klodell, T. M. Beaver, M. T. Bologna, P. Mikhail, C. G. Tribble, and T. D. Martin Early Outcomes Using the Florida Sleeve Repair for Correction of Aortic Insufficiency due to Root Aneurysms Ann. Thorac. Surg., April 1, 2009; 87(4): 1161 - 1169. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. V. Volguina, D. C. Miller, S. A. LeMaire, L. C. Palmero, X. L. Wang, H. M. Connolly, T. M. Sundt III, J. E. Bavaria, H. C. Dietz, D. M. Milewicz, et al. Valve-sparing and valve-replacing techniques for aortic root replacement in patients with Marfan syndrome: analysis of early outcome. J. Thorac. Cardiovasc. Surg., March 1, 2009; 137(3): 641 - 649. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Komiya, N. Tamura, G. Sakaguchi, and T. Kobayashi Modified partial aortic root remodeling in acute type A aortic dissection Interactive CardioVascular and Thoracic Surgery, March 1, 2009; 8(3): 306 - 309. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Goland and U. Elkayam Cardiovascular Problems in Pregnant Women With Marfan Syndrome Circulation, February 3, 2009; 119(4): 619 - 623. [Full Text] [PDF]
|
|
|
|
|
|
T. Hanke, E. I. Charitos, U. Stierle, D. Robinson, A. Gorski, H.-H. Sievers, and M. Misfeld Factors associated with the development of aortic valve regurgitation over time after two different techniques of valve-sparing aortic root surgery. J. Thorac. Cardiovasc. Surg., February 1, 2009; 137(2): 314 - 319. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Roubertie, W. B. Ali, O. Raisky, D. Tamisier, D. Sidi, and P. R. Vouhe Aortic root replacement in children: a word of caution about valve-sparing procedures Eur. J. Cardiothorac. Surg., January 1, 2009; 35(1): 136 - 140. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Tourmousoglou and C. Rokkas Is aortic valve-sparing operation or replacement with a composite graft the best option for aortic root and ascending aortic aneurysm? Interactive CardioVascular and Thoracic Surgery, January 1, 2009; 8(1): 134 - 147. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. A. Nienaber, I. Akin, R. Erbel, and A. Haverich CHAPTER 31 Diseases of the Aorta and Trauma to the Aorta and the Heart ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Girdauskas, T. Kuntze, M. A. Borger, V. Falk, and F. W. Mohr Distal Aortic Reinterventions After Root Surgery in Marfan Patients Ann. Thorac. Surg., December 1, 2008; 86(6): 1815 - 1819. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Katayama, N. Umetani, S. Sugiura, and T. Hisada The sinus of Valsalva relieves abnormal stress on aortic valve leaflets by facilitating smooth closure. J. Thorac. Cardiovasc. Surg., December 1, 2008; 136(6): 1528 - 1535. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Marcheix, H. Rousseau, V. Bongard, R. H. Heijmen, C. A. Nienaber, M. Ehrlich, P. Amabile, J.-P. Beregi, and R. Fattori Stent Grafting of Dissected Descending Aorta in Patients With Marfan's Syndrome: Mid-Term Results J. Am. Coll. Cardiol. Intv., December 1, 2008; 1(6): 673 - 680. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. J.J. Aalberts, T. W. Waterbolk, J. P. van Tintelen, H. L. Hillege, P. W. Boonstra, and M. P. van den Berg Prophylactic aortic root surgery in patients with Marfan syndrome: 10 years' experience with a protocol based on body surface area Eur. J. Cardiothorac. Surg., September 1, 2008; 34(3): 589 - 594. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. D. Patel, E. S. Weiss, D. E. Alejo, L. U. Nwakanma, J. A. Williams, H. C. Dietz, P. J. Spevak, V. L. Gott, L. A. Vricella, and D. E. Cameron Aortic Root Operations for Marfan Syndrome: A Comparison of the Bentall and Valve-Sparing Procedures Ann. Thorac. Surg., June 1, 2008; 85(6): 2003 - 2011. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Ogino, K. Minatoya, H. Matsuda, and H. Sasaki Easy Technique for Placing Anchoring Sutures for Aortic Root Reimplantation Asian Cardiovasc Thorac Ann, April 1, 2008; 16(2): 162 - 163. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. E. David Aortic Valve Repair and Aortic Valve Sparing Operations Card. Surg. Adult, January 1, 2008; 3(2008): 935 - 948. [Full Text]
|
|
|
|
|
|
D. Aicher, F. Langer, H. Lausberg, B. Bierbach, and H.-J. Schafers Aortic root remodeling: Ten-year experience with 274 patients. J. Thorac. Cardiovasc. Surg., October 1, 2007; 134(4): 909 - 915. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. S. Kalkat, I. Rahman, K. Kotidis, B. Davies, and R. S. Bonser Presentation and outcome of Marfan's syndrome patients with dissection and thoraco-abdominal aortic aneurysm Eur. J. Cardiothorac. Surg., August 1, 2007; 32(2): 250 - 254. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Kallenbach, M. Karck, and A. Haverich Valve-sparing aortic root replacement: the inclusion (David) technique MMCTS, May 7, 2007; 2007(0507): 1917. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Lansac, I. Di Centa, F. Raoux, R. Raffoul, N. Al Attar, A. Rama, C. Acar, and P. Nataf Aortic annuloplasty: towards a standardized approach of conservative aortic valve surgery MMCTS, March 29, 2007; 2007(0329): 1958. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. G. Svensson, E. H. Blackstone, J. Feng, D. de Oliveira, A. M. Gillinov, M. Thamilarasan, R. A. Grimm, B. Griffin, D. Hammer, T. Williams, et al. Are Marfan Syndrome and Marfanoid Patients Distinguishable on Long-Term Follow-Up? Ann. Thorac. Surg., March 1, 2007; 83(3): 1067 - 1074. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. E. David, C. M. Feindel, G. D. Webb, J. M. Colman, S. Armstrong, and M. Maganti Aortic Valve Preservation in Patients With Aortic Root Aneurysm: Results of the Reimplantation Technique Ann. Thorac. Surg., February 1, 2007; 83(2): S732 - S735. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. C. Miller Valve-Sparing Aortic Root Replacement: Current State of the Art and Where Are We Headed? Ann. Thorac. Surg., February 1, 2007; 83(2): S736 - S739. [Full Text] [PDF]
|
|
|
|
|
|
A. W. Erasmi, H.-H. Sievers, J.F. M. Bechtel, T. Hanke, U. Stierle, and M. Misfeld Remodeling or Reimplantation for Valve-Sparing Aortic Root Surgery? Ann. Thorac. Surg., February 1, 2007; 83(2): S752 - S756. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kallenbach, H. Baraki, N. Khaladj, H. Kamiya, C. Hagl, A. Haverich, and M. Karck Aortic Valve-Sparing Operation in Marfan Syndrome: What Do We Know After a Decade? Ann. Thorac. Surg., February 1, 2007; 83(2): S764 - S768. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Settepani, W. Y. Szeto, D. Pacini, R. De Paulis, L. Chiariello, R. Di Bartolomeo, R. Gallotti, and J. E. Bavaria Reimplantation Valve-Sparing Aortic Root Replacement in Marfan Syndrome Using the Valsalva Conduit: An Intercontinental Multicenter Study Ann. Thorac. Surg., February 1, 2007; 83(2): S769 - S773. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N C Radu, E W M Kirsch, M-L Hillion, F Lagneau, L Drouet, and D Loisance Embolic and bleeding events after modified Bentall procedure in selected patients Heart, January 1, 2007; 93(1): 107 - 112. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. F. Lausberg and H.-J. Schafers Valve sparing aortic replacement - root remodeling MMCTS, November 10, 2006; 2006(1110): 1982. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Pacini, F. Settepani, R. De Paulis, A. Loforte, S. Nardella, D. Ornaghi, R. Gallotti, L. Chiariello, and R. Di Bartolomeo Early results of valve-sparing reimplantation procedure using the Valsalva conduit: a multicenter study. Ann. Thorac. Surg., September 1, 2006; 82(3): 865 - 871. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. F. Lausberg, D. Aicher, F. Langer, and H.-J. Schafers Aortic valve repair with autologous pericardial patch. Eur. J. Cardiothorac. Surg., August 1, 2006; 30(2): 244 - 249. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. E. David, C. M. Feindel, G. D. Webb, J. M. Colman, S. Armstrong, and M. Maganti Long-term results of aortic valve-sparing operations for aortic root aneurysm. J. Thorac. Cardiovasc. Surg., August 1, 2006; 132(2): 347 - 354. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. LeMaire, S. A. Carter, I. V. Volguina, A. T. Laux, D. M. Milewicz, G. W. Borsato, C. K. Cheung, J. Bozinovski, J. M. Markesino, W. K. Vaughn, et al. Spectrum of Aortic Operations in 300 Patients With Confirmed or Suspected Marfan Syndrome Ann. Thorac. Surg., June 1, 2006; 81(6): 2063 - 2078. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Erbel and H. Eggebrecht Aortic dimensions and the risk of dissection Heart, January 1, 2006; 92(1): 137 - 142. [Full Text] [PDF]
|
|
|
|
|
|
R. De Paulis, R. Scaffa, S. Forlani, and L. Chiariello The Valsalva graft in aortic valve repair and replacement MMCTS, November 29, 2005; 2005(1129): 992. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. A. Vricella, J. A. Williams, W. J. Ravekes, K. W. Holmes, H. C. Dietz, V. L. Gott, and D. E. Cameron Early Experience With Valve-Sparing Aortic Root Replacement in Children Ann. Thorac. Surg., November 1, 2005; 80(5): 1622 - 1627. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Albes, U. A. Stock, and M. Hartrumpf Restitution of the Aortic Valve: What is New, What is Proven, and What is Obsolete? Ann. Thorac. Surg., October 1, 2005; 80(4): 1540 - 1549. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kallenbach, M. Karck, D. Pak, R. Salcher, N. Khaladj, R. Leyh, C. Hagl, and A. Haverich Decade of Aortic Valve Sparing Reimplantation: Are We Pushing the Limits Too Far? Circulation, August 30, 2005; 112(9_suppl): I-253 - I-259. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Markl, M. T. Draney, D. C. Miller, J. M. Levin, E. E. Williamson, N. J. Pelc, D. H. Liang, and R. J. Herfkens Time-resolved three-dimensional magnetic resonance velocity mapping of aortic flow in healthy volunteers and patients after valve-sparing aortic root replacement J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 456 - 463. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Maselli, A. Montalto, G. Santise, G. Minardi, C. Manzara, and F. Musumeci A normogram to anticipate dimension of neo-sinuses of valsalva in valve-sparing aortic operations Eur. J. Cardiothorac. Surg., May 1, 2005; 27(5): 831 - 835. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. J. Meijboom, F. E. Vos, J. Timmermans, G. H. Boers, A. H. Zwinderman, and B. J.M. Mulder Pregnancy and aortic root growth in the Marfan syndrome: a prospective study Eur. Heart J., May 1, 2005; 26(9): 914 - 920. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Y. Kim, N. Martin, E. C. Hsia, R. E. Pyeritz, and D. A. Albert Management of Aortic Disease in Marfan Syndrome: A Decision Analysis Arch Intern Med, April 11, 2005; 165(7): 749 - 755. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Milewicz, H. C. Dietz, and D. C. Miller Treatment of Aortic Disease in Patients With Marfan Syndrome Circulation, March 22, 2005; 111(11): e150 - e157. [Full Text] [PDF]
|
|
|
|
|
|
V. Anttila, M. Piaszczynski, B. Mora, I. Hagino, R. V. Lacro, D. Zurakowski, and R. A. Jonas Improved outcome with composite graft versus homograft root replacement for children with aortic root aneurysms Eur. J. Cardiothorac. Surg., March 1, 2005; 27(3): 420 - 424. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Demers and D. C. Miller Simple Modification of "T. David-V" Valve-Sparing Aortic Root Replacement to Create Graft Pseudosinuses Ann. Thorac. Surg., October 1, 2004; 78(4): 1479 - 1481. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. J. Zehr, T. A. Orszulak, C. J. Mullany, A. Matloobi, R. C. Daly, J. A. Dearani, T. M. Sundt III, F. J. Puga, G. K. Danielson, and H. V. Schaff Surgery for Aneurysms of the Aortic Root: A 30-Year Experience Circulation, September 14, 2004; 110(11): 1364 - 1371. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kallenbach, T. Oelze, R. Salcher, C. Hagl, M. Karck, R. G. Leyh, and A. Haverich Evolving Strategies for Treatment of Acute Aortic Dissection Type A Circulation, September 14, 2004; 110(11_suppl_1): II-243 - II-249. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Sioris, T. E. David, J. Ivanov, S. Armstrong, and C. M. Feindel Clinical outcomes after separate and composite replacement of the aortic valve and ascending aorta J. Thorac. Cardiovasc. Surg., August 1, 2004; 128(2): 260 - 265. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kallenbach, R.G. Leyh, R. Salcher, M. Karck, C. Hagl, and A. Haverich Acute aortic dissection versus aortic root aneurysm: comparison of indications for valve sparing aortic root reconstruction Eur. J. Cardiothorac. Surg., May 1, 2004; 25(5): 663 - 670. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Furukawa, H. Ohteki, Z.-L. Cao, Y. Narita, Y. Okazaki, S. Ohtsubo, and T. Itoh Evaluation of native valve-sparing aortic root reconstruction with direct imaging-- reimplantation or remodeling? Ann. Thorac. Surg., May 1, 2004; 77(5): 1636 - 1641. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Karck, K. Kallenbach, C. Hagl, C. Rhein, R. Leyh, and A. Haverich Aortic root surgery in Marfan syndrome: Comparison of aortic valve-sparing reimplantation versus composite grafting J. Thorac. Cardiovasc. Surg., February 1, 2004; 127(2): 391 - 398. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Del Campo Aortic insufficiency in patients with Marfan syndrome: A surgical dilemma J. Thorac. Cardiovasc. Surg., January 1, 2004; 127(1): 303 - 304. [Full Text] [PDF]
|
|
|
|
|
|
D. C. Miller Valve-sparing aortic root replacement in patients with the Marfan syndrome J. Thorac. Cardiovasc. Surg., April 1, 2003; 125(4): 773 - 778. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
