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Cardiovascular Reoperations in Marfan Syndrome
Author(s) -
Erentug Vedat,
Polat Adil,
Bozbuga Nilgun Ulusoy,
Polat Ebru,
Erdogan Hasan Basri,
Kirali Kaan,
Guler Mustafa,
Akinci Esat,
Yakut Cevat
Publication year - 2006
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2006.00276.x
Subject(s) - medicine , ascending aorta , marfan syndrome , surgery , confidence interval , aneurysm , aortic dissection , dissection (medical) , aortic aneurysm , proportional hazards model , aorta
Background and aim of the study: The purpose of this study is to analyze the outcome results of reoperations in Marfan syndrome patients. Methods: Between 1985 and December 2004, 49 patients with Marfan syndrome were operated for aortic aneurysms. Of these 49 patients, 9 (18,4%) required ≥1 reoperations after a mean duration of 32.2 ± 26.6 months. The mean duration of follow‐up was 52.0 ± 46.8 months, a total of 39 patient/years. Survival free of reoperation was calculated by Cox regression analysis. Results: Surgical indication for operation was a chronic aneurysmal dilatation of the ascending or abdominal aorta in seven patients (77.8%) and aortic dissection in two (22.2%) at the initial operation. In the reoperations, repair of thoracoabdominal aortic aneurysm with separated graft interposition in six patients (66.7%), replacement of ascending aorta in one (11.1%), replacement of ascending and hemiarchus aorta in one (11.1%), and mitral valve replacement in three patients (33.3%) were performed. The hospital mortality was 11.1% with one patient. Among the survivors, one expired in the follow‐up five months after the second operation (12.5%). With the Cox regression analysis, survival without reoperation for 13, 24, and 123 months are
95.56 ± 3.04%, 90.66 ± 4.40%, and 60.32 ± 12.63%, respectively. Mean survival for reoperated patients is 99 ± 14 months (95% confidence interval 72–127 months). Conclusions: Reoperations can be done with low morbidity and mortality. Patients should be kept under close follow‐up using imaging techniques infinitely.