Early and Late Results of Graft Replacement for Dissecting Aneurysm of Thoracoabdominal Aorta in Patients With Marfan Syndrome

Omura, Atsushi; Tanaka, Akiko; Miyahara, Shunsuke; Sakamoto, Toshihito; Nomura, Yoshikatsu; Inoue, Takeshi; Oka, Toshihiko; Minami, Hiroya; Okada, Kenji; Okita, Yutaka

doi:10.1016/j.athoracsur.2012.04.061

Cited by 32 publications

(13 citation statements)

References 20 publications

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“…Of note, we found that patients with dissection generally had fewer comorbidities than patients with degenerative aneurysm without dissection (Table 6), with the caveat that some of the health conditions we studied (eg, hyperlipidemia, coronary artery disease, cerebrovascular disease) are typically associated with the aging process itself. Clearly, there are select groups of patients who should expect good to excellent outcomes after even the most extensive TAAA repair (extent II repair); typically, this includes patients aged 50 years or less, patients with connective tissue disorders, 34,35 and to a lesser extent, patients with chronic aortic dissection. 36 Likewise, there are select groups of patients for whom extent II TAAA repair might exceed a reasonable level of risk, such as octogenarians.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of 3309 thoracoabdominal aortic aneurysm repairs

Coselli

LeMaire

Preventza

et al. 2016

The Journal of Thoracic and Cardiovascular Surgery

516

421

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Section: Discussionmentioning

confidence: 99%

Outcomes of 3309 thoracoabdominal aortic aneurysm repairs

Coselli

LeMaire

Preventza

et al. 2016

The Journal of Thoracic and Cardiovascular Surgery

516

421

View full text Add to dashboard Cite

show abstract

“…This may be due to intraoperative circulatory arrest, hypothermic extracorporeal circulation, massive blood transfusion, and systemic inflammatory response syndrome induced by surgical shock in patients undergoing aortic arch surgery, which severely affects the respiratory system (15). Despite advances in surgical techniques in recent years, the risk of aortic arch surgery remains high (17). In contrast, the David (reimplantation) surgical procedure had lower complications and mortality (16,18,19).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of cardiovascular surgery for Marfan syndrome patients: a single-center 15-year follow-up study

Zhang¹,

Xue²,

Tang³

et al. 2020

J Thorac Dis

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Background: Most Marfan syndrome (MFS) patients have thoracic aortic diseases which is the major cause of death. The aim of the study is to analyze the impact of different surgical procedures on prognosis of MFS patients. Methods: We retrospectively analyzed the results of hospitalization and long-term follow-up of MFS patients who underwent surgical intervention in our center. Results: Of the 135 MFS patients, 11 died during hospitalization (8.1%). There were no statistical differences in in-hospital mortality between the proximal surgery group and the distal surgery group (P=0.11). Compared to patients who underwent proximal aortic surgery, patients who underwent arch and distal surgery were more likely to have postoperative respiratory dysfunction (P=0.008). The type of surgical procedure was not associated with the incidence of complications during hospitalization. Pre-surgical New York Heart Association (NYHA) Functional Classification IV (P=0.047), EF <50% (P=0.047), pre-surgical atrial fibrillation (P=0.042), and the injury of dissection propagating onto coronary arteries (P=0.02) were independent risk factors for post-surgical mortality. After 15 years of follow-up, there were no deaths in the David group, while the 15-year survival rate for patients in the Bentall group was 73%±13.5%, and 71%±13.9% for patients in the arch surgery group (P=0.42). The probability of patients in the David group not requiring re-surgery after 15 years was 58.9%±20%, while it was 58.7%±12.1% for patients in the Bentall group, 71.5%±10.5% for patients in the Bentall + Arch group, and 12.5%±11.7% for patients in the Arch + Stent group (P=0.007). Conclusions: The David procedure was the most beneficial and had the highest long-term patient survival rates.

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“…It is important to note that thoracic aortic dissection can occur in patients with genetic disorders such as Marfan's, Loeys-Dietz, and Ehlers-Danlos syndromes at normal aortic diameters, and these patients are therefore monitored over time with serial imaging for evidence of change in size and morphology rather than using absolute diameter threshold [11]. In addition, patients with these disorders who present with thoraco-abdominal aortic dissection are in some instances treated with complete graft repair and visceral [14].…”

Section: Thoracic Aortic Aneurysmmentioning

confidence: 98%

Role of Computed Tomography in Assessment of the Thoracic Aorta

Meyersohn

Ghemigian

Shapiro

et al. 2015

Curr Treat Options Cardio Med

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Thoracic aortic disease is increasing in prevalence and can result in serious morbidity and mortality. Computed tomography (CT) angiography is an important imaging modality for assessment of thoracic aortic pathology due to wide availability, rapid acquisition, reproducibility, superior spatial and temporal resolution, and capability for 3D image post-processing. CT is the preferred imaging modality in the acute setting to rapidly identify patients with acute aortic syndromes including dissection, intramural hematoma, and penetrating aortic ulcer. CT also plays an important role in post-procedural surveillance of the thoracic aorta for early and late complications from open or endovascular repair. Incidentally detected thoracic aortic aneurysms and congenital aortic anomalies such as coarctation can be thoroughly characterized and followed over time for potential elective intervention. Drawbacks of CT include exposure to radiation and iodinated contrast media; however, recent strategies for dose reduction and contrast optimization have significantly decreased these risks. Electrocardiogram (ECG)-gated CT angiography provides additional information about the aortic root, coronary arteries, and other cardiac structures without motion artifacts.

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Early and Late Results of Graft Replacement for Dissecting Aneurysm of Thoracoabdominal Aorta in Patients With Marfan Syndrome

Cited by 32 publications

References 20 publications

Outcomes of 3309 thoracoabdominal aortic aneurysm repairs

Outcomes of 3309 thoracoabdominal aortic aneurysm repairs

Efficacy of cardiovascular surgery for Marfan syndrome patients: a single-center 15-year follow-up study

Role of Computed Tomography in Assessment of the Thoracic Aorta

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