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Titolo:
COMPOSITE GRAFT REPAIR OF MARFAN ANEURYSM OF THE ASCENDING AORTA - RESULTS IN 150 PATIENTS
Autore:
GOTT VL; CAMERON DE; PYERITZ RE; GILLINOV AM; GREENE PS; STONE CD; ALEJO DE; MCKUSICK VA;
Indirizzi:
JOHNS HOPKINS UNIV HOSP,618 BLALOCK BLDG,600 N WOLFE ST BALTIMORE MD 21287
Titolo Testata:
Journal of cardiac surgery
fascicolo: 5, volume: 9, anno: 1994,
pagine: 482 - 489
SICI:
0886-0440(1994)9:5<482:CGROMA>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
NO
Recensione:
Indirizzi per estratti:
Citazione:
V.L. Gott et al., "COMPOSITE GRAFT REPAIR OF MARFAN ANEURYSM OF THE ASCENDING AORTA - RESULTS IN 150 PATIENTS", Journal of cardiac surgery, 9(5), 1994, pp. 482-489

Abstract

One hundred fifty consecutive Marfan patients undergoing composite graft repair of an ascending aorta aneurysm are reported. Twenty-six of the 150 patients had a preoperative dissection of the ascending aorta. There were no early deaths among 138 patients undergoing elective composite graft repair. There was one early death among 12 patients undergoing urgent operation; this patient arrived at the hospital with a rupturing aneurysm. Twenty-four of the 150 patients had mitral procedures; there were no early deaths in this group. There have been 14 late deaths among the 149 hospital survivors (9%). Actuarial survival of 150patients at 1, 5, 10, and 14 years was 93%, 92%, 81%, and 73% respectively. Risk factors for early or late death were identified by multivariate analysis and only New York Heart Association class (III or IV) and male gender emerged as significant independent predictors of mortality. Late complications directly related to the composite graft have been gratifyingly low; only 2 patients had coronary dehiscence and 3 had thromboembolic events. Endocarditis emerged as an important late complication in 8 patients (5%). Two patients were successfully treated with antibiotics, 3 died before widespread availability of cryopreserved homografts, and 3 patients treated with antibiotics and homograft root replacement have had no evidence of recurrent infection. Seven patients with dissection in this series had aortic diameters of 6.5 cm or less. This experience supports the concept that composite graft repairin Marfan patients is mandated when the aneurysm reaches 5.5 to 6 cm,even in the asymptomatic patient. With a family history of dissection, operative intervention should occur when the aneurysm reaches 5 cm in diameter.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/11/20 alle ore 07:14:50