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Aortic valve-sparing surgery in Marfan syndrome
Eyal Nachum1, Amichay Shinfeld, Alexander Kogan
1Department of Cardiac Surgery, Sheba Medical Center, Tel Hashomer, Israel. Eyal.Nachum@sheba.health.gov.il
The Israel Medical Association Journal : IMAJ
|October 2, 2013
Summary
Aortic valve-sparing surgery is safe and effective for Marfan syndrome patients, showing good mid-term results with no reoperations needed. This cardiac surgery offers durable outcomes for these young patients with aortic root aneurysms.
Area of Science:
- Cardiovascular Surgery
- Genetics
- Cardiology
Background:
- Marfan syndrome patients often require cardiac surgery for aortic root aneurysm.
- Valve-sparing procedures are common in young Marfan patients, but long-term durability is a concern.
- Genetic factors in Marfan syndrome raise questions about surgical outcomes.
Purpose of the Study:
- To evaluate the safety and durability of aortic valve-sparing surgery in Marfan syndrome patients.
- To assess mid-term clinical and echocardiographic outcomes.
- To compare outcomes between Marfan and non-Marfan patients undergoing the procedure.
Main Methods:
- 100 patients with aortic aneurysm and regurgitation underwent elective valve-sparing surgery (2004-2012).
- 30 patients had Marfan syndrome, were younger, and had higher rates of root aneurysm.
- Evaluated safety, durability, and clinical/echocardiographic mid-term results.
Main Results:
- No early or late deaths in either group.
- Marfan patients showed excellent functional class (96% NYHA I-II).
- 94% freedom from severe aortic regurgitation; no Marfan patients required aortic valve reoperation.
Conclusions:
- Aortic valve-sparing surgery is safe for Marfan syndrome patients.
- The procedure demonstrates good mid-term clinical outcomes in this population.
- Valve-sparing surgery is a viable option for Marfan patients with aortic aneurysms.
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