Extensive aortic reconstruction for aortic aneurysms in Marfan syndrome

Niinami, Hiroshi; Aomi, Shigeyuki; Tagusari, Osamu; Hashimoto, A; Koyanagi, Hitoshi

doi:10.1016/s0003-4975(99)00438-5

Cited by 27 publications

(23 citation statements)

References 13 publications

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“…This result implies that it is relatively rare for patients with Marfan syndrome to have the initial aortic lesion in the abdominal aorta. 18 In our current study, we described the precise characteristics and long-term outcome after surgical treatment for patients with Marfan syndrome, who had not a dissecting but a true AAA as the initial aortic lesion.…”

Section: Discussionmentioning

confidence: 99%

True abdominal aortic aneurysm in Marfan syndrome

Takayama

Miyata

Nagawa

2009

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

True abdominal aortic aneurysm in Marfan syndrome

Takayama

Miyata

Nagawa

2009

Journal of Vascular Surgery

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“…Note the gradual increase in ratio and expansion rate with progressive disease and the significant increase prior to a recommendation for surgery. [3,8,10,22]. This survival is achieved despite the challenge of fragile aortic tissue and the operative extent of repair.…”

Section: Discussionmentioning

confidence: 99%

“…Two Extent III patients underwent repair utilising partial cardiopulmonary bypass and aortic clamping. The mean CPB and HCA were 246 min (95% CL 217-278) and 21 min (95% CL [16][17][18][19][20][21][22][23][24], respectively. The mean intercostals, hypogastric, visceral and renal ischaemic times (15 8C) were 40 min (95% CL 34-46), 51 min (95% CL 34-69), 92 min (95% CL 38-167) and 86 min (95% CL 32-139), respectively.…”

Section: Operative Details and Outcomesmentioning

confidence: 98%

Presentation and outcome of Marfan's syndrome patients with dissection and thoraco-abdominal aortic aneurysm

Kalkat

Rahman

Kotidis

et al. 2007

European Journal of Cardio-Thoracic Surgery

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Background: In Marfan's syndrome, there is a paucity of data regarding intervention criteria for surgery of the dissected thoraco-abdominal aorta. Methods: A retrospective analysis of 22 Marfan's patients with distal aortic dissection managed between September 1999 and April 2006 was performed. Serial diameters and linear expansion rates were calculated from imaging studies and the outcome of intervention was analysed.Results: There were 14/22 male patients (median age 38 years), and 18 had prior aortic surgery. Surgery was recommended in 20 patients and undertaken in 19 (1 died prior to operation). Of the operated patients, 2 presented with rupture, 2 with airway obstruction, 1 with intermittent paraplegia and 14 underwent planned surgery for increased expansion rate or pain. All patients had residual type A or chronic type B dissection. The median aortic dimension at surgery was 6.7 cm (interquartile range (IQR) 5.5-8.2). The preoperative mean expansion rate increased from 0.5 cm/year to 1.7 cm/year ( p < 0.001), prior to operation. Fifteen patients underwent Crawford Extent II, two underwent Extent I and two underwent Extent III repair. Profound hypothermia and CSF drainage was used in 16 and 18 patients, respectively. There was no early mortality, paraplegia or renal failure. At a median postoperative follow-up of 56 months (range 6-86), the survival of the operated cohort was 90%. Conclusions: Thoraco-abdominal aortic aneurysm repair in Marfan's syndrome can be performed with good outcomes. Intervention should be based on size or accelerated expansion. Any role of endovascular management needs careful consideration. #

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“…Several studies found that the ascending aorta was the most common site of the first operation. [14][15][16][19][20][21][22] Most of the patients in this series underwent aortic root replacement as their initial aortic operation.…”

Section: Discussionmentioning

confidence: 99%

“…Several institutes have recently used deep hypothermic circulatory arrest with retrograde cerebral perfusion for reconstruction of the aortic arch. Niinami et al 20 reported that the incidence of brain dysfunction was correspondingly low when the retrograde cerebral perfusion technique was used; however, the antegrade selective perfusion technique provides optimal surgical repair without time restraints or the need for profound hypothermia.…”

Section: Discussionmentioning

confidence: 99%