Reimplantation valve-sparing aortic root replacement in Marfan syndrome using the Valsalva conduit: an intercontinental multicenter study.

Abstract

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.

• Authors: Fabrizio Settepani, Wilson Y Szeto, Davide Pacini, Ruggero De Paulis, Luigi Chiariello, Roberto Di Bartolomeo, Roberto Gallotti, Joseph E Bavaria
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 83 Issue 2 Pg. S769-73; discussion S785-90 (Feb 2007) ISSN: 1552-6259 [Electronic] Netherlands
• PMID: 17257924 (Publication Type: Journal Article, Multicenter Study)

Topics

• Adolescent
• Adult
• Aorta (surgery)
• Aortic Diseases (etiology, surgery)
• Aortic Valve (physiopathology, surgery)
• Aortic Valve Insufficiency (etiology, surgery)
• Blood Vessel Prosthesis Implantation
• Female
• Follow-Up Studies
• Heart Valve Prosthesis Implantation
• Humans
• Male
• Marfan Syndrome (complications)
• Middle Aged
• Reoperation
• Replantation (adverse effects)
• Retrospective Studies
• Treatment Outcome