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Ann Thorac Surg 1991;52:38-45
© 1991 The Society of Thoracic Surgeons

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Articles

Composite graft repair of Marfan aneurysm of the ascending aorta: Results in 100 patients

Division of Cardiac Surgery and the Center for Medical Genetics of The Johns Hopkins Medical Institutions, Baltimore, Maryland USA

^_* Address reprint requests to Dr Gott, 618 Blalock Bldg, 600 N Wolfe St, The Johns Hopkins Hospital, Baltimore, MD 21205.

	Abstract

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One hundred consecutive patients with the Marfan syndrome underwent composite graft repair of an ascending aortic aneurysm between September 1976 and June 1989. Twenty-two patients had ascending aortic dissection at the time of composite graft repair; 18 patients also had a mitral valve procedure. There were no hospital deaths among 92 patients undergoing elective repair. One of 8 patients undergoing emergency repair of a ruptured aneurysm died in the operating room. The overall hospital mortality rate was 1%. There have been ten late deaths among the 99 hospital survivors (10.1%). Five deaths occurred among the first 11 patients in this series and five occurred among the last 88 patients (5.7%). Three late deaths resulted from composite graft endocarditis; 3 other patients with endocarditis are alive after aortic root replacement with cryopreserved homografts. Late coronary dehiscence caused death in 1 patient and was successfully repaired in a second. Actuarial survival for the 100 patients was 92.6% at 5 years and 75.8% at 10 years. Currently, composite graft repair of Marfan aneurysms of the ascending aorta can be performed with low hospital and late mortality. Marfan aneurysms with a diameter of 6 cm or greater should be repaired with the Bentall composite graft procedure, even if the patient is asymptomatic.

	Footnotes

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Presented at the Thirty-seventh Annual Meeting of the Southern Thoracic Surgical Association, Dorado, Puerto Rico, Nov 8–10, 1990.

	References

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1. Bentall HH, DeBono A. A technique for complete replacement of the ascending aorta Thorax 1968;23:338-339.[Abstract/Free Full Text]
2. McDonald GR, Schaff HV, Pyeritz RE, McKusick VA, Gott VL. Surgical management of patients with the Marfan syndrome and dilatation of the ascending aorta J Thorac Cardiovasc Surg 1981;81:180-186.[Abstract]
3. Gott VL, Pyeritz RE, Magovern GJ, Cameron DE, McKusick VA. Surgical treatment of aneurysms of the ascending aorta in the Marfan syndrome N Engl J Med 1986;314:1070-1074.[Medline]
4. Beighton P, de Paepe A, Danks D, et al. International nosology of heritable disorders of connective tissueBerlin, 1986 Am J Med Genet 1988;29:581-584.[Medline]
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6. Helseth HK, Haglin JJ, Monson BK, Wickstrom PH. Results of composite graft replacement for aortic root aneurysms J Thorac Cardiovasc Surg 1980;80:754-759.[Abstract]
7. Kouchoukos NT, Marshall WG, Wedige-Stecher TA. Eleven-year experience with composite graft replacement of the ascending aorta and aortic valve J Thorac Cardiovasc Surg 1986;92:691-705.[Abstract]
8. Svensson LG, Crawford ES, Coselli JS, Safi HJ, Hess KR. Impact of cardiovascular operation on survival in the Marfan patient Circulation 1989;80(Suppl 1):233-242.
9. Crawford ES, Svensson LG, Coselli JS, Safi HJ, Hess KR. Surgical treatment of aneurysm and/or dissection of the ascending aorta, transverse aortic arch, and ascending aorta and transverse aortic arch J Thorac Cardiovasc Surg 1989;98:659-674.[Abstract]
10. Raudkivi PJ, Williams JD, Monro JL, Ross JK. Surgical treatment of the ascending aorta J Thorac Cardiovasc Surg 1989;98:675-682.[Abstract]

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This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gott, V. L. Articles by McKusick, V. A. Search for Related Content PubMed PubMed Citation Articles by Gott, V. L. Articles by McKusick, V. A.