Valve-sparing aortic root replacement (David I procedure) in Marfan disease: single-centre 20-year experience in more than 100 patients†

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Andreas MartensMalakh Shrestha

Abstract

Valve-sparing aortic root replacement (VSARR) is recommended for patients with aortic root dilatation and preserved aortic valve cusp morphology. The durability of VSARR in Marfan patients has been questioned. The aim of our study was to establish the long-term outcomes of VSARR in Marfan patients. Between 1993 and 2015, 582 patients underwent VSARR (David I reimplantation) at our institution. Of these patients, 104 had Marfan disease. Thirteen surgeons performed the procedures in this group. The mean follow-up time was 12 ± 5.4 years (1201 patient-years). Early mortality was 0.96%, and long-term survival was 91% at 10 years and 76% at 20 years in Marfan patients. Marfan patients had a significantly better survival compared to non-Marfan patients (P < 0.0001). Freedom from aortic-valve reoperation was 86% at 10 years and 80% at 20 years in Marfan patients. The reoperation rate was similar in Marfan and non-Marfan patients (P = 0.60). Morphological perioperative features (untreated prolapse, commissural plasty, cusp plasty and graft size mismatch) predicted long-term mortality (P = 0.0054). Graft size mismatch and untreated prolapse predicted structural valve deterioration (both P < 0.0001). Long-term valve function in event-fre...Continue Reading

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Citations

Dec 14, 2019·Current Opinion in Cardiology·Ruggero De PaulisIlaria Chirichilli
May 15, 2020·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Markus LiebrichVladimir Voth
Apr 4, 2020·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Erik BeckmannMalakh Lal Shrestha
Jun 24, 2020·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Erik BeckmannMalakh Lal Shrestha
Aug 8, 2020·Interactive Cardiovascular and Thoracic Surgery·Petr NemecPetr Fila
Oct 17, 2020·Indian Journal of Thoracic and Cardiovascular Surgery : Official Organ, Association of Thoracic and Cardiovascular Surgeons of India·Saadallah TamerLaurent de Kerchove
Jan 28, 2021·Scandinavian Cardiovascular Journal : SCJ·Antti HuuskonenPeter Raivio
Mar 30, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Erik BeckmannMalakh Lal Shrestha
Aug 28, 2021·The Journal of Thoracic and Cardiovascular Surgery·Mina FaragUNKNOWN German Registry for Acute Aortic Dissection Type A Working Group of the German Society of Thoracic, Cardiac and Vascular Sur
Oct 12, 2021·The Journal of Thoracic and Cardiovascular Surgery·Joseph S CoselliUNKNOWN Aortic Valve Operative Outcomes in Marfan Patients Study Group

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European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Erik BeckmannMalakh Shrestha
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