Reimplantation Valve-Sparing Aortic Root Replacement in Marfan Syndrome Using the Valsalva Conduit: An Intercontinental Multicenter Study

Settepani, Fabrizio; Szeto, Wilson Y.; Pacini, Davide; Paulis, Ruggero De; Chiariello, Luigi; Bartolomeo, Roberto Di; Gallotti, Roberto; Bavaria, Joseph E.

doi:10.1016/j.athoracsur.2006.10.084

Cited by 47 publications

(36 citation statements)

References 26 publications

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“…The average follow-up for period for CVG in 13 studies reporting follow up duration was 7.14 years and the average follow up period for VSRR in 20 studies reporting follow up duration was 4.5 years. There were 2 studies reporting the outcomes of CVG only (11,19) and 8 studies reporting the outcomes of VSRR only (15,17,20,22,23,26,28,31). Thirteen studies reported outcomes for both CVG and VSRR (12)(13)(14)16,18,21,24,25,27,29,30,32,33).…”

Section: Resultsmentioning

confidence: 99%

Systematic review and meta-analysis of surgical outcomes in Marfan patients undergoing aortic root surgery by composite-valve graft or valve sparing root replacement

Flynn

Tian

Wilson-Smith

et al. 2017

Ann. Cardiothorac. Surg.

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Background: A major, life-limiting feature of Marfan syndrome (MFS) is the presence of aneurysmal disease. Cardiovascular intervention has dramatically improved the life expectancy of Marfan patients.Traditionally, the management of aortic root disease has been undertaken with composite-valve graft replacing the aortic valve and proximal aorta; more recently, valve sparing procedures have been developed to avoid the need for anticoagulation. This meta-analysis assesses the important surgical outcomes of the two surgical techniques.Methods: A systematic review and meta-analysis of 23 studies reporting the outcomes of aortic root surgery in Marfan patients with data extracted for outcomes of early and late mortality, thromboembolic events, late bleeding complications and surgical reintervention rates.Results: The outcomes of 2,976 Marfan patients undergoing aortic root surgery were analysed, 1,624 patients were treated with composite valve graft (CVG) and 1,352 patients were treated with valve sparing root replacement (VSRR). When compared against CVG, VSRR was associated with reduced risk of thromboembolism (OR =0.32; 95% CI, 0.16-0.62, P=0.0008), late hemorrhagic complications (OR =0.18; 95% CI, 0.07-0.45; P=0.0003) and endocarditis (OR =0.27; 95% CI, 0.10-0.68; P=0.006). Importantly there was no significant difference in reintervention rates between VSRR and CVG (OR =0.89; 95% CI, 0.35-2.24; P=0.80).Conclusions: There is an increasing body of evidence that VSRR can be reliably performed in Marfan patients, resulting in a durable repair with no increased risk of re-operation compared to CVG, thus avoiding the need for systemic anticoagulation in selected patients.

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Section: Resultsmentioning

confidence: 99%

Systematic review and meta-analysis of surgical outcomes in Marfan patients undergoing aortic root surgery by composite-valve graft or valve sparing root replacement

Flynn

Tian

Wilson-Smith

et al. 2017

Ann. Cardiothorac. Surg.

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“…Many individuals can receive a valve-sparing procedure that precludes the need for chronic anticoagulation therapy. 45,46 Children run the highest risk of requiring repeated cardiac operations, such as valve replacement. 47 Aortic dilation can also be seen in the descending aorta, although typically at later ages.…”

Section: Figurementioning

confidence: 99%

Health Supervision for Children With Marfan Syndrome

Tinkle¹,

Saal²,

Saul³

et al. 2013

Pediatrics

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“…83 Although differences can be seen in long-term freedom from aortic regurgitation between the 2 valve-sparing techniques, with the reimplantation approach being more favorable, mortality outcomes of either are excellent. 83,84 A registry of patients who have an aortic valve-sparing procedure is collecting data from an international consortium of surgeons, and additional outcome data will emerge in the next few years. More detailed discussions of surgical options can be found elsewhere.…”

Section: Timing Of Aortic Surgical Intervention In Marfan Syndromementioning

confidence: 99%

Medical Management of Marfan Syndrome

2008

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Reimplantation Valve-Sparing Aortic Root Replacement in Marfan Syndrome Using the Valsalva Conduit: An Intercontinental Multicenter Study

Cited by 47 publications

References 26 publications

Systematic review and meta-analysis of surgical outcomes in Marfan patients undergoing aortic root surgery by composite-valve graft or valve sparing root replacement

Systematic review and meta-analysis of surgical outcomes in Marfan patients undergoing aortic root surgery by composite-valve graft or valve sparing root replacement

Health Supervision for Children With Marfan Syndrome

Medical Management of Marfan Syndrome

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