Authors
M Bashir3; T Magruder4; G Mariscalco1; M Fok3; M Shaw3; J D Dunning2; A Oo3; D E Cameron4;
1 Glenfield General Hospital, Leicester; 2 James Cook University Hospital; 3 Liverpool Heart and Chest Hospital; 4 The Johns Hopkins University School of Medicine, United States
Objective
The optimal treatment for aortic root disease in Marfan patients has not been determined. We sought to identify a large international cohort of Marfan patients to compare the operative outcomes following Bentall and valve sparing aortic root repair (VSRR).
Methods
All VSRR and Bentall operations performed on Marfans patients were identified in the UK and at John Hopkins Medical Center through the National Institute Cardiovascular Outcomes Research (NICOR) which holds data on every cardiac operation performed in the UK, and chart review at John Hopkins from 2007 and 2014.
Results
Patients who underwent Bentall were significantly older (p = 0.002), more aortic dissections (p<0.001), and underwent urgent or emergency surgery (p<0.001), compared to VSRR. Post-operative complications revealed no difference in cerebrovascular accidents and reoperation for bleeding. There was no observed difference for in-hospital mortality between the two procedures (1 vs 0, respectively, p=0.47). 5 year survival stratified by procedure was significantly lower in the Bentall compared to VSRR.
Conclusion
Our preliminary results reveal no superiority in outcomes for Marfan patients undergoing Bentall or VSRR. However, 5 year survival is significantly higher for patients undergoing VSRR.
