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Ann Thorac Surg 2007;83:S769-S773
© 2007 The Society of Thoracic Surgeons

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Supplement

Reimplantation Valve-Sparing Aortic Root Replacement in Marfan Syndrome Using the Valsalva Conduit: An Intercontinental Multicenter Study

^a Cardiac Surgery Department, Istituto Clinico Humanitas, Rozzano, Italy
^b Division of Cardiothoracic Surgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
^c Cardiac Surgery Department, University of Bologna, Bologna
^d Cardiac Surgery Department, Tor Vergata University, Roma, Italy

Accepted for publication October 24, 2006.

^_* Address correspondence to Dr Settepani, Department of Cardiac Surgery, Istituto Clinico Humanitas, Via Manzoni 56, 20089 Rozzano (MI), Italy. (Email: fabrizio.settepani{at}humanitas.it).

Presented at Aortic Surgery Symposium X, New York, NY, April 27–28, 2006.

BACKGROUND: Introduced by DePaulis in 2000, the Gelweave Valsalva graft (Sulzer Vascutek, Refrewshire, Scotland) is a modified Dacron conduit (DuPont, Wilmington, DE), with prefashioned sinuses of Valsalva. The aim of this study was to evaluate the mid-term results of the reimplantation valve-sparing aortic root replacement using the Gelweave Valsalva prosthesis in Marfan syndrome patients.

METHODS: A retrospective review was performed of 35 patients with Marfan syndrome in four centers who underwent the reimplantation valve-sparing aortic root replacement using the Gelweave Valsalva prosthesis.

RESULTS: The patients were predominantly men, with a mean age of 36.5 ± 12.6 years (range, 14 to 62 years). Two patients presented with acute type A dissections and underwent emergent operations. Elective hemiarch reconstruction using hypothermic circulatory arrest was required in 11 patients. Aortic valve cusp repair was performed in 2 patients. There were no operative or hospital deaths, and no patients died during follow-up. The mean follow-up was 19 months (range, 1 to 60 months). Significant (>2+) aortic insufficiency (AI), requiring aortic valve replacement, developed in 3 patients during follow-up that requiring aortic valve replacement. The 5-year freedom from reoperation owing to structural valve deterioration was 88.9% ± 8.1%. There were no episodes of clinically significant thromboembolism.

CONCLUSIONS: Reimplantation valve-sparing aortic root replacement with the Gelweave Valsalva prosthesis in Marfan patients provides satisfactory mid-term results, thus encouraging further use of this type of repair. However, long-term results are needed in order to define the durability of this technique.

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