Surgical treatment of cardiovascular complications in Marfan syndrome: a 27-year experience

Détails

ID Serval
serval:BIB_4719B15A9836
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Surgical treatment of cardiovascular complications in Marfan syndrome: a 27-year experience
Périodique
European Journal of Cardio-Thoracic Surgery
Auteur(s)
Pasic  M., von Segesser  L., Carrel  T., Laske  A., Bauer  E., Turina  M.
ISSN
1010-7940
Statut éditorial
Publié
Date de publication
1992
Peer-reviewed
Oui
Volume
6
Numéro
3
Pages
149-54; discussion 155
Notes
Journal Article
Résumé
Fifty-two patients with Marfan syndrome and ascending aortic pathology were treated surgically between 1964 and 1990. The indication for primary operation was true aneurysm of the ascending aorta with or without aortic insufficiency in 35 patients (67%) and dissection in 17 (33%). Composite grafts were used in 28 patients (54%; group I) and other procedures on the ascending aorta in 24 patients (46%; group II). The latter included supracoronary graft replacement with or without aortic valve replacement or reconstruction (n = 13), and reconstruction of the ascending aorta with or without aortic valve replacement (n = 11). Composite graft insertion was combined with mitral valve surgery at the same operation in 3 patients (6%). The early mortality after primary operations was 7.7% (4 deaths) and the late mortality was 27% (14 deaths). Eight late deaths were related to cardiovascular complications. The mean follow-up was 6.7 years (range 1-27 years). The actuarial 5-, 10-, and 15-year survival rates for all patients were 82%, 63%, and 44%, respectively; for group I (composite grafts) they were 87%, 76%, and 57%; and for group II (other types of operations) they were 73%, 53%, and 37%. The incidence of late complications was much higher in group II than in group I (50% vs. 16%). At 5 and 10 years, the actuarial rates of freedom from late complications related to the primary operation were 88% and 80%, respectively, in group I and 65% and 18% in group II. Composite graft insertion is the operation of choice when approaching the ascending aorta and/or aortic valve in Marfan syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)
Mots-clé
Adolescent Adult Aneurysm, Dissecting/complications/surgery Aortic Aneurysm/complications/mortality/*surgery Aortic Valve Insufficiency/complications/mortality/*surgery Blood Vessel Prosthesis Female Follow-Up Studies Heart Valve Prosthesis Humans Male Marfan Syndrome/*complications/mortality Middle Aged Postoperative Complications Reoperation Survival Rate
Pubmed
Web of science
Création de la notice
14/02/2008 15:15
Dernière modification de la notice
03/03/2018 16:49
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