Short-term follow-up of valve-sparing aortic root replacement in Marfan syndrome / 中华胸心血管外科杂志

ABSTRACT

Objective To evaluate the short-term follow-up of valve-sparing aortic root replacement in Marfan syndrome. Methods 54 patients, 38 males and 16 females;aged(20-50) years, mean(31. 26 ± 7. 80) years old. They were all diag-nosed with Marfan syndrome according to the criteria of Ghent in 1996. Preoperative ultrasound showed 5 cases with trace aortic valve regurgitation, a small amount of reflux in 12 cases, 22 cases in the middle amount of regurgitation, 15 cases with a large number of reflux. According to the surgery program it was devided into 2 groups, Bentall group(35 cases, Bentall surgery) and David group(19 cases, David surgery). Follow-up 12 months to 48 months, to compare the differences of the efficacy of differ-ent surgical options,before and after surgery. Results 2 cases died after operation, one patient in group bentall died of uncon-trollable bleeding and the other in group David died of pulmonary infection, multiple organ failure, and the remaining 52 cases recoveredwell.GroupbentallwhichCPB(141.09±15.483)min,aorticocclusion(93.82±15.06)min. GroupDavid,CPB (186.32 ±23.96)min, aortic occlusion(140.21 ±22.13) min. There are significant differences in postoperative EF value, left ventricular diameter and postoperative left ventricular systolic volume ( ESV ) , postoperative left ventricular end-diastolic volume(EDV), FS improvement with preoperative data(P<0. 05), and there were no significant differences(P>0. 05) be-tween the two groups. The early postoperative complications were no significant difference between the tuo groups, bue the late complications in group bentall was significantly higher than groups David. Patients were followed up for 12 months to 48 months, one patient in David group underwent aortic valve replacement surgery because of severe aortic regurgitation. One case ( abdominal aorta) in group Bentall underwent surgery due to recurrent dissection and 6 cases with bleeding, embolic complica-tions because of warfarin. Conclusion Valve sparing root replacement has provided satisfactory short-term outcomes for Marfan syndrome.