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J Thorac Cardiovasc Surg 2009;137:1131-1132
© 2009 The American Association for Thoracic Surgery

Invited Commentary

Discussion

Dr Alan D. Hilgenberg (Boston, Mass). Dr Coselli, congratulations to you and your colleagues for designing and implementing this very important study. The presentation is a report of the current practice of aortic root repair in patients with MFS from centers in Europe and North and South America. First of all, it is remarkable that there was no 30–day mortality in 151 patients, attesting to the safety of these complex surgical procedures. Seventy percent of the operations were valve-sparing, all but two of them were of the reimplantation type, and about two thirds included repair with sinuses.

The patients undergoing AVR were different from those undergoing AVS in several important characteristics. They were older, they had more preoperative aortic regurgitation, and they underwent more nonelective operations. These factors probably will affect the long–term results in addition to the presence of a mechanical valve when comparisons with the outcomes of AVS patients are made.

The most important information from this study will come from the years of follow-up data that we hope you will accumulate. The late results of composite valve graft replacement in patients with MFS have been reported at least a couple of times in the last several years. Survival at 10 years . . . [Full Text of this Article]