• Vincent L Gott, Duke E Cameron, Diane E Alejo, Peter S Greene, Jay G Shake, David J Caparrelli, and Harry C Dietz.
• Division of Cardiac Surgery, the Institute of Genetic Medicine and the Howard Hughes Medical Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA. vgott@csurg.jhmi.jhu.edu
• Ann. Thorac. Surg. 2002 Feb 1;73(2):438-43.

BackgroundThe introduction of composite graft repair of aortic root aneurysm by Hugh Bentall in 1968 promised Marfan patients the choice for a normal life expectancy. We performed our first Bentall composite graft procedure in 1976 and herein report our 24-year experience with 271 Marfan patients.MethodsBetween September 1976 and August 2000, 232 Marfan patients had a composite graft replacement of the aortic root, 15 patients received a homograft, and 24 had a valve-sparing procedure.ResultsTwo hundred thirty-five Marfan patients underwent elective aortic root replacement with no 30-day mortality. Two early deaths occurred among 36 patients who underwent urgent or emergent operation. Eighty-three percent of patients in this series are currently alive. The actuarial freedom from thromboembolism, endocarditis, and reoperation on the residual aorta 20 years postoperatively was 93%, 90%, and 74%. Twenty-four patients have undergone valve-sparing procedures with encouraging results.ConclusionsElective aortic root replacement for Marfan patients can be performed with low operative risk. Elective repair before the aortic root reaches 6 cm in diameter is recommended to minimize risk of dissection and rupture.

34 keywords...

hide…