ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Vincent L. Gott
Duke E. Cameron
Diane E. Alejo
Peter S. Greene
Jay G. Shake
David J. Caparrelli
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gott, V. L.
Right arrow Articles by Dietz, H. C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gott, V. L.
Right arrow Articles by Dietz, H. C.
Related Collections
Right arrow Great vessels

Ann Thorac Surg 2002;73:438-443
© 2002 The Society of Thoracic Surgeons

Original article: cardiovascular

Aortic root replacement in 271 Marfan patients: a 24-year experience1

Vincent L. Gott, MD*a, Duke E. Cameron, MDa, Diane E. Alejo, BAa, Peter S. Greene, MDa, Jay G. Shake, MDa, David J. Caparrelli, MDa, Harry C. Dietz, MDa

a Division of Cardiac Surgery, the Institute of Genetic Medicine and the Howard Hughes Medical Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA

Accepted for publication September 19, 2001.

* Address reprint requests to Dr Gott, 618 Blalock Building, The Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, MD 21287, USA
e-mail: vgott{at}csurg.jhmi.jhu.edu

Background. The 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.

Methods. Between 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.

Results. Two 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.

Conclusions. Elective 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.




This article has been cited by other articles:


Home page
 Eur. J. Cardiothorac. Surg.Home page
J. J.J. Aalberts, T. W. Waterbolk, J. P. van Tintelen, H. L. Hillege, P. W. Boonstra, and M. P. van den Berg
Prophylactic aortic root surgery in patients with Marfan syndrome: 10 years' experience with a protocol based on body surface area
Eur. J. Cardiothorac. Surg., September 1, 2008; 34(3): 589 - 594.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. E. David, S. Armstrong, M. Maganti, and L. Ihlberg
Clinical outcomes of combined aortic root replacement with mitral valve surgery
J. Thorac. Cardiovasc. Surg., July 1, 2008; 136(1): 82 - 87.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
N. D. Patel, E. S. Weiss, D. E. Alejo, L. U. Nwakanma, J. A. Williams, H. C. Dietz, P. J. Spevak, V. L. Gott, L. A. Vricella, and D. E. Cameron
Aortic root operations for marfan syndrome: a comparison of the bentall and valve-sparing procedures.
Ann. Thorac. Surg., June 1, 2008; 85(6): 2003 - 2011.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
H. V. Schaff and R. M. Suri
Multiple Valve Disease
Card. Surg. Adult, January 1, 2008; 3(2008): 1129 - 1158.
[Full Text]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
S. A. LeMaire and J. S. Coselli
Options for managing infected ascending aortic grafts.
J. Thorac. Cardiovasc. Surg., October 1, 2007; 134(4): 839 - 843.
[Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
M. S. Kalkat, I. Rahman, K. Kotidis, B. Davies, and R. S. Bonser
Presentation and outcome of Marfan's syndrome patients with dissection and thoraco-abdominal aortic aneurysm
Eur. J. Cardiothorac. Surg., August 1, 2007; 32(2): 250 - 254.
[Abstract] [Full Text] [PDF]

Home page
 Eur J EchocardiogrHome page
H. J. Redruello, T. F. Cianciulli, E. F. Rostello, B. Recalde, J. A. Lax, V. P. Picone, S. M. Belforte, and H. A. Prezioso
Monozygotic twins with Marfan's syndrome and ascending aortic aneurysm
Eur J Echocardiogr, August 1, 2007; 8(4): 302 - 306.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
C. Knosalla, Y.-g. Weng, R. Hammerschmidt, M. Pasic, I. Schmitt-Knosalla, O. Grauhan, M. Dandel, H. B. Lehmkuhl, and R. Hetzer
Orthotopic Heart Transplantation in Patients With Marfan Syndrome
Ann. Thorac. Surg., May 1, 2007; 83(5): 1691 - 1695.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
L. A. Vricella and D. E. Cameron
Facile conversion from mechanical to bioprosthetic composite aortic root replacement
J. Thorac. Cardiovasc. Surg., February 1, 2007; 133(2): 565 - 567.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. A. Williams, B. L. Loeys, L. U. Nwakanma, H. C. Dietz, P. J. Spevak, N. D. Patel, K. Francois, J. DeBacker, V. L. Gott, L. A. Vricella, et al.
Early Surgical Experience With Loeys-Dietz: A New Syndrome of Aggressive Thoracic Aortic Aneurysm Disease
Ann. Thorac. Surg., February 1, 2007; 83(2): S757 - S763.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
P M Engelfriet, E Boersma, J G P Tijssen, B J Bouma, and B J M Mulder
Beyond the root: dilatation of the distal aorta in Marfan's syndrome
Heart, September 1, 2006; 92(9): 1238 - 1243.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
L. Svensson
Invited commentary
Ann. Thorac. Surg., August 1, 2006; 82(2): 546 - 547.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
N. D. Patel, J. A. Williams, C. J. Barreiro, B. T. Bethea, T. P. Fitton, H. C. Dietz, J. A.C. Lima, P. J. Spevak, V. L. Gott, L. A. Vricella, et al.
Valve-Sparing Aortic Root Replacement: Early Experience With the De Paulis Valsalva Graft in 51 Patients
Ann. Thorac. Surg., August 1, 2006; 82(2): 548 - 553.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
B. Lima, G. C. Hughes, A. Lemaire, J. Jaggers, D. D. Glower, and W. G. Wolfe
Short-Term and Intermediate-Term Outcomes of Aortic Root Replacement with St. Jude Mechanical Conduits and Aortic Allografts
Ann. Thorac. Surg., August 1, 2006; 82(2): 579 - 585.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
S. A. LeMaire, S. A. Carter, I. V. Volguina, A. T. Laux, D. M. Milewicz, G. W. Borsato, C. K. Cheung, J. Bozinovski, J. M. Markesino, W. K. Vaughn, et al.
Spectrum of Aortic Operations in 300 Patients With Confirmed or Suspected Marfan Syndrome
Ann. Thorac. Surg., June 1, 2006; 81(6): 2063 - 2078.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
F. Jault, A. Rama, L. Lievre, N. Bonnet, P. Leprince, A. Pavie, and I. Gandjbakhch
Chronic dissection of the ascending aorta: surgical results during a 20-year period (previous surgery excluded).
Eur. J. Cardiothorac. Surg., June 1, 2006; 29(6): 1041 - 1045.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
R. Di Bartolomeo, D. Pacini, S. Martin-Suarez, A. Loforte, A. Dell'Amore, M. Ferlito, G. Bracchetti, and G. Bozzetti
Valsalva prosthesis in aortic valve-sparing operations
Interactive CardioVascular and Thoracic Surgery, June 1, 2006; 5(3): 294 - 298.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
L. A. Vricella, J. A. Williams, W. J. Ravekes, K. W. Holmes, H. C. Dietz, V. L. Gott, and D. E. Cameron
Early Experience With Valve-Sparing Aortic Root Replacement in Children
Ann. Thorac. Surg., November 1, 2005; 80(5): 1622 - 1627.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
R. De Paulis, C. Schmitz, R. Scaffa, P. Nardi, L. Chiariello, and H. Reul
In vitro evaluation of aortic valve prosthesis in a novel valved conduit with pseudosinuses of Valsalva
J. Thorac. Cardiovasc. Surg., October 1, 2005; 130(4): 1016 - 1021.
[Abstract] [Full Text] [PDF]

Home page
 Arch Intern MedHome page
S. Y. Kim, N. Martin, E. C. Hsia, R. E. Pyeritz, and D. A. Albert
Management of Aortic Disease in Marfan Syndrome: A Decision Analysis
Arch Intern Med, April 11, 2005; 165(7): 749 - 755.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
D. Baumgartner, C. Baumgartner, G. Matyas, B. Steinmann, J. Loffler-Ragg, E. Schermer, U. Schweigmann, I. Baldissera, B. Frischhut, J. Hess, et al.
Diagnostic power of aortic elastic properties in young patients with Marfan syndrome
J. Thorac. Cardiovasc. Surg., April 1, 2005; 129(4): 730 - 739.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
V. Anttila, M. Piaszczynski, B. Mora, I. Hagino, R. V. Lacro, D. Zurakowski, and R. A. Jonas
Improved outcome with composite graft versus homograft root replacement for children with aortic root aneurysms
Eur. J. Cardiothorac. Surg., March 1, 2005; 27(3): 420 - 424.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
M. Enriquez-Sarano and A. J. Tajik
Aortic Regurgitation
N. Engl. J. Med., October 7, 2004; 351(15): 1539 - 1546.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
B. T. Bethea, T. P. Fitton, D. E. Alejo, C. J. Barreiro, S. M. Cattaneo, H. C. Dietz, P. J. Spevak, J. A. C. Lima, V. L. Gott, and D. E. Cameron
Results of aortic valve-sparing operations: Experience with remodeling and reimplantation procedures in 65 patients
Ann. Thorac. Surg., September 1, 2004; 78(3): 767 - 772.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. Sioris, T. E. David, J. Ivanov, S. Armstrong, and C. M. Feindel
Clinical outcomes after separate and composite replacement of the aortic valve and ascending aorta
J. Thorac. Cardiovasc. Surg., August 1, 2004; 128(2): 260 - 265.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
F. Onorati, L. S. De Santo, A. Carozza, M. De Feo, A. Renzulli, and M. Cotrufo
Marfan syndrome as a predisposing factor for traumatic aortic insufficiency
Ann. Thorac. Surg., June 1, 2004; 77(6): 2192 - 2194.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
O. Tagusari, H. Ogino, J. Kobayashi, K. Bando, K. Minatoya, H. Sasaki, K. Niwaya, Y. Okita, M. Ando, T. Yagihara, et al.
Should the transverse aortic arch be replaced simultaneously with aortic root replacement for annuloaortic ectasia in Marfan syndrome?
J. Thorac. Cardiovasc. Surg., May 1, 2004; 127(5): 1373 - 1380.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. Karck, K. Kallenbach, C. Hagl, C. Rhein, R. Leyh, and A. Haverich
Aortic root surgery in Marfan syndrome: Comparison of aortic valve-sparing reimplantation versus composite grafting
J. Thorac. Cardiovasc. Surg., February 1, 2004; 127(2): 391 - 398.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
S. M. Cattaneo, B. T. Bethea, D. E. Alejo, P. J. Spevak, S. B. Clauss, H. C. Dietz, V. L. Gott, and D. E. Cameron
Surgery for aortic root aneurysm in children: a 21-Year experience in 50 patients
Ann. Thorac. Surg., January 1, 2004; 77(1): 168 - 176.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
R. A. Hopkins
Aortic valve leaflet sparing and salvage surgery: evolution of techniques for aortic root reconstruction
Eur. J. Cardiothorac. Surg., December 1, 2003; 24(6): 886 - 897.
[Abstract] [Full Text] [PDF]

Home page
 Asian Cardiovasc. Thorac. Ann.Home page
K. Kirali, V. Erentug, M. B Rabus, A. Izgi, N. U Bozbuga, K. Erkanli, E. Akinci, and C. Yakut
Extensive Aortic Surgery in Marfan Syndrome: 16-Year Experience
Asian Cardiovasc Thorac Ann, December 1, 2003; 11(4): 337 - 341.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. Kazui, K. Yamashita, H. Terada, N. Washiyama, T. Suzuki, K. Ohkura, and K. Suzuki
Late reoperation for proximal aortic and arch complications after previous composite graft replacement in marfan patients
Ann. Thorac. Surg., October 1, 2003; 76(4): 1203 - 1207.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
F. F. Immer, A. G. Bansi, A. S. Immer-Bansi, J. McDougall, K. J. Zehr, H. V. Schaff, and T. P. Carrel
Aortic dissection in pregnancy: analysis of risk factors and outcome
Ann. Thorac. Surg., July 1, 2003; 76(1): 309 - 314.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
N. C. de Oliveira, T. E. David, J. Ivanov, S. Armstrong, M. J. Eriksson, H. Rakowski, and G. Webb
Results of surgery for aortic root aneurysm in patients with Marfan syndrome
J. Thorac. Cardiovasc. Surg., April 1, 2003; 125(4): 789 - 796.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
H. V. Schaff and D. H. Marsh
Multiple Valve Disease
Card. Surg. Adult, January 1, 2003; 2(2003): 1017 - 1045.
[Full Text]

Home page
 Ann. Thorac. Surg.Home page
D. Roux, L. Brouchet, H. Rousseau, T. Elghobary, Y. Glock, and G. Fournial
Treatment of a fistula at the distal anastomosis after Bentall operation with endoluminal covered stent
Ann. Thorac. Surg., December 1, 2002; 74(6): 2189 - 2190.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2002 by The Society of Thoracic Surgeons.