Primary Cardiac Impairment in Patients With Marfan Syndrome Undergoing a Bentall Procedure

Xu, Hao; Jiang, Wenjian; Joshi, Yashutosh; Han, Lu; Li, Haiyang; Lan, Feng; Zhu, Jun; Sun, Li‐Zhong; Gong, Ming; Zhang, Hongjia

doi:10.1016/j.athoracsur.2020.10.044

Cited by 4 publications

(3 citation statements)

References 18 publications

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“…In addition, a meta‐analysis showed that Marfan patients had a lower LVEF than controls. These findings are in accordance with the results from our previous study 24 . In our previous study, we attempted to explore the difference in perioperative cardiac structure and function between Marfan patients and matched non‐Marfan patients with an aortic root aneurysm.…”

Section: Discussionsupporting

confidence: 90%

“…These findings are in accordance with the results from our previous study. 24 In our previous study, we attempted to explore the difference in perioperative cardiac structure and function between Marfan patients and matched non-Marfan patients with an aortic root aneurysm. We found that Marfan patients presented with a lower postoperative LVEF than controls, even though the patients from the two groups underwent similar cardiac surgery techniques (Bentall procedure).…”

Section: Discussionmentioning

confidence: 99%

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Intrinsic left ventricular impairment in Marfan syndrome: A systematic review and meta‐analysis

Guo

et al. 2021

Journal of Cardiac Surgery

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Background: Intrinsic cardiac impairment in Marfan syndrome (MFS) has been explored in many clinical studies; however, their results have been inconsistent. This meta-analysis aimed to assess the difference in cardiac structure and function between Marfan patients and healthy individuals, and to verify the hypothesis of intrinsic cardiac impairment in MFS.Methods: Electronic searches for studies were performed in the PubMed, Embase, and Cochrane Library databases. Nine studies with 490 patients with MFS and 478 controls were included in the analysis. Age and sex were strictly matched between Marfan patients and healthy controls in every study. Results: There was no difference in the left ventricular end systolic diameter index (mean difference [MD]: 0.33; 95% confidence interval [CI]: (−0.24, 0.89); p = 0.26) and left ventricular end diastolic diameter index (MD: 0.18; 95% CI: [−0.47, 0.83]; p = 0.58) between Marfan patients and controls. Marfan patients showed larger left ventricular end systolic volume index (MD: 2.62; 95% CI: [0.27, 4.97]; p = 0.03) and left ventricular end diastolic volume index (MD: 4.16; 95% CI: [2.70, 5.63]; p < 0.01) than the control group. Furthermore, Marfan patients showed a lower left ventricular ejection fraction than healthy people (MD: −2.59%; 95% CI: [−4.64%, −0.54%]; p = 0.01). Conclusions: Intrinsic cardiac impairment was observed in MFS. MFS patients showed the larger left ventricular volume and poorer left ventricular function than matched controls. Considering the potentially adverse impact on cardiac function, intrinsic cardiac impairment in MFS should be considered during the cardiac surgery.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Intrinsic left ventricular impairment in Marfan syndrome: A systematic review and meta‐analysis

Guo

et al. 2021

Journal of Cardiac Surgery

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“…Two out of seven patients in the reintervention subgroup (3 out of 105, successfully followed-up MFS subgroup) died, but cardiac and mitral valve dysfunction remained the main cause of death in our cohort. As recently shown by Xu and colleagues ( 32 ), MFS patients may suffer from primary cardiac impairment, which has a negative effect on postoperative cardiac adverse events.…”

Section: Discussionmentioning

confidence: 79%

Fate of the distal aorta following root replacement in Marfan syndrome: a propensity score matched study

Líu

Chen

Luo

et al. 2023

Front. Cardiovasc. Med.

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ObjectiveThe aortic root is the most frequent segment involved in Marfan syndrome. However, Marfan syndrome is a systemic hereditary connective tissue disorder, and knowledge regarding the outcomes of the native distal aorta after prophylactic aortic root surgery is limited.MethodsFrom April 2010 to December 2020, 226 patients with Marfan syndrome and 1,200 patients without Marfan syndrome who underwent Bentall procedures were included in this study. By propensity score matching, 134 patients were assigned to each group. Clinical manifestations and follow-up data were acquired from hospital records and telephone contact. The cumulative incidence of aortic events was estimated in Marfan and non-Marfan patients with death as a competing risk.ResultsPatients with and without Marfan syndrome had similar baseline characteristics after propensity score matching. Differences in the aortic root (62.25 ± 11.96 vs. 54.03 ± 13.76, P < .001) and ascending aorta (37.71 ± 9.86 vs. 48.16 ± 16.01, P < .001) remained after matching. No difference was observed in the frequency of aortic adverse events between the two groups (10.5% vs. 4.6%, P = 0.106). The cumulative incidence of aortic events was not different between Marfan and non-Marfan patients (15.03% ± 4.72% vs. 4.18% ± 2.06%, P = 0.147). Multivariate Cox regression indicated no significant impact of Marfan syndrome on distal aortic events (HR: 1.172, 95% CI: 0.263–5.230, P = 0.835). Descending and abdominal aortic diameter above normal at the initial procedure were associated with the risk of distal aortic events (HR: 20.735, P = .003, HR: 22.981, P = .002, respectively).ConclusionsNew-onset events of the residual aorta in patients undergoing Bentall procedures between the Marfan and non-Marfan groups were not significantly different. Distal aortic diameter above normal at initial surgery was associated with a higher risk of adverse aortic events.

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Abnormal Left Ventricular Strain Correlates with Left Ventricular Dysfunction but not Aortic Pathology in Marfan Syndrome in Children

et al. 2023

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Primary Cardiac Impairment in Patients With Marfan Syndrome Undergoing a Bentall Procedure

Cited by 4 publications

References 18 publications

Intrinsic left ventricular impairment in Marfan syndrome: A systematic review and meta‐analysis

Intrinsic left ventricular impairment in Marfan syndrome: A systematic review and meta‐analysis

Fate of the distal aorta following root replacement in Marfan syndrome: a propensity score matched study

Abnormal Left Ventricular Strain Correlates with Left Ventricular Dysfunction but not Aortic Pathology in Marfan Syndrome in Children

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