You Position: Home > Paper

Snrgical treatment of the aortic root aneurysm related to Marfan syndrome

( views:393, downloads:86 )
Author:
No author available
Journal Title:
China Medicine
Issue:
11
DOI:
10.3760/cma.j.issn.1673-4777.2011.11.004
Key Word:
马方综合征;主动脉根部瘤;心脏外科手术;手术指征;Marfan syndrome;Aortic aneurysm;Cardiac surgical procedure;Indications for surgery

Abstract: Objective To review the experience of surgical treatment of aortic root aneurysm of Marfan syndrome and to discuss the indications and the methods of surgical treatment.Methods We reviewed 113 cases receiving surgical treatment from February 1995 to August 2009 for aortic root aneurysm of Marfan syndrome.The New York Heart Association (NYHA) cardiac function was class Ⅱ in 70 cases,class Ⅲ in 32 cases and class ⅣV in 11cases.Fifty-nine cases presented with aortic dissection ( DeBakey type Ⅰ in 50 cases,type Ⅱ in 9 cases),moderate to severe aortic regurgitation in 81 cases,moderate to severe mitral regurgitation in 9 cases.The mean diameter of aortic root aneurysm was (68 ± 15)mm,Bentall procedure was performed in 97 cases,Wheat procedure in 6 cases,cabrol procedure in 6 cases,Aortic valve replacement and aortoplasty in 4 cases.Concomitant procedure were mitral value replacement and mitral valvuloplasty in 6 cases,coronary artery bypass grafting in 2 cases,total aortic arch replacement with stented elephant trunk procedure in 3 cases,respectively.Emergency surgery was done in 40 cases,elective operation in 73 cases.Results The entire postoperative drainage was 190-1750 (641 ± 403 )ml;there were 3 cases(2.6% ) in-hospital deaths.One hundred and two patients were followed up for a mean duration of (78 ± 49) months.Late death occurred in 5 cases.Seven patients underwent reoperation,thoracic or abdominal aortic aneurysm operation had 3 cases,severe aortic insufficiency of aortic valve replacement had one case,severe mitral regurgitation in mitral valve replacement had 2 cases,perivalvular leak repair had one case.And NYHA class Ⅲ was in 4 cases,out of them was in NYHA class Ⅰ - Ⅱ.One years,5 years and 8 year survival rates of the patients were 98.0%,93.1% and 87.3%.Conclusions Bentall procedure should be the first choice of the aortic root aneurysm of Marfan syndrome,with a low mortality and good late survival.Prophylactic surgery should be recommended to minimize risk of dissection and rupture if aortic root diameter is greater than 4.5 cm for Chinese.

WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn