The Journal of Thoracic and Cardiovascular Surgery
Volume 138, Issue 5 , Pages 1108-1114 , November 2009

Stent graft repair of descending aortic dissection in patients with Marfan syndrome: An effective alternative to open reoperation?

  • Luca Botta, MD

      Affiliations

    • Cardiac Surgery Unit, Cardiothoracovascular Department, University Hospital S. Orsola, Bologna, Italy
    • ,
  • Vincenzo Russo, MD

      Affiliations

    • Cardiovascular Radiology Unit, Cardiothoracovascular Department, University Hospital S. Orsola, Bologna, Italy
    • ,
  • Cesare La Palombara, MD

      Affiliations

    • Cardiovascular Radiology Unit, Cardiothoracovascular Department, University Hospital S. Orsola, Bologna, Italy
    • ,
  • Marzia Rosati, MD

      Affiliations

    • Cardiovascular Radiology Unit, Cardiothoracovascular Department, University Hospital S. Orsola, Bologna, Italy
    • ,
  • Roberto Di Bartolomeo, MD

      Affiliations

    • Cardiac Surgery Unit, Cardiothoracovascular Department, University Hospital S. Orsola, Bologna, Italy
    • ,
  • Rossella Fattori, MD

      Affiliations

    • Cardiovascular Radiology Unit, Cardiothoracovascular Department, University Hospital S. Orsola, Bologna, Italy
    • Corresponding Author InformationAddress for reprints: Rossella Fattori, MD, Cardiothoracovascular Department (Pad 21), University Hospital S. Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy.

Received 6 December 2008 ,Revised 9 February 2009 ,Accepted 8 March 2009.

References 

  1. Judge DP, Dietz HC. Marfan's syndrome. Lancet. 2005;366:1965–1976
  2. Baril TD, Carroccio A, Palchik E, Ellozy SH, Jacobs TS, Teodorescu V, et al. Endovascular treatment of complicated aortic aneurysms in patients with underlying arteriopathies. Ann Vasc Surg. 2006;20:464–471
  3. Niinami H, Aomi S, Tagusari O, Hashimoto A, Koyanagi H. Extensive aortic reconstruction for aortic aneurysms in Marfan syndrome. Ann Thorac Surg. 1999;67:1864–1867
  4. Carrel T, Beyeler L, Schnyder A, Zurmuhle P, Berdat P, Schmidli J, et al. Reoperations and late adverse outcome in Marfan patients following cardiovascular surgery. Eur J Cardiothorac Surg. 2004;25:671–675
  5. Milewicz DM, Dietz HC, Miller DC. Treatment of aortic disease in patients with Marfan syndrome. Circulation. 2005;111:150–157
  6. Karck M, Kallenbach K, Hagl C, Rhein C, Leyh R, Haverich A. Aortic root surgery in Marfan syndrome: comparison of aortic valve-sparing reimplantation versus composite grafting. J Thorac Cardiovasc Surg. 2004;127:391–398
  7. Gott VL, Greene PS, Alejo DE, Cameron DE, Naftel DC, Miller DC, et al. Replacement of the aortic root in patients with Marfan's syndrome. N Engl J Med. 1999;340:1307–1313
  8. Sasaki S, Yasuda K, Kunihara T, Shiiya N, Murashita T, Matsui Y, et al. Surgical results of Stanford type B aortic dissection. Comparisons between partial and subtotal replacement of the dissected aorta. J Cardiovasc Surg (Torino). 2000;41:227–232
  9. Fattori R, Tsai TT, Myrmel T, Evangelista A, Cooper JV, Trimarchi S, et al. Complicated acute type B dissection: is surgery still the best option?: a report from the International Registry of Acute Aortic Dissection. J Am Coll Cardiol Intv. 2008;1:395–402
  10. Umana JP, Lai DT, Mitchell RS, Moore KA, Rodriguez F, Robbins RC, et al. Is medical therapy still the optimal treatment strategy for patients with acute type B aortic dissections?. J Thorac Cardiovasc Surg. 2002;124:896–910
  11. Estrera AL, Miller CC, Safi HJ, Goodrick JS, Keyhani A, Porat EE, et al. Outcomes of medical management of acute type B aortic dissection. Circulation. 2006;114(suppl):I384–I389
  12. De Paepe A, Devereux RB, Dietz HC, Hennekam RC, Pyeritz RE. Revised diagnostic criteria for the Marfan syndrome. Am J Med Genet. 1996;62:417–426
  13. Smith JA, Fann JI, Miller DC, Moore KA, DeAnda A, Mitchell RS, et al. Surgical management of aortic dissection in patients with the Marfan syndrome. Circulation. 1994;90:II235–II242
  14. Gott VL, Cameron DE, Alejo DE, Greene PS, Shake JG, Caparrelli DJ, et al. Aortic root replacement in 271 Marfan patients: a 24-year experience. Ann Thorac Surg. 2002;73:438–443
  15. Settepani F, Szeto WY, Pacini D, De Paulis R, Chiariello L, Di Bartolomeo R, et al. Reimplantation valve-sparing aortic root replacement in Marfan syndrome using the Valsalva conduit: an intercontinental multicenter study. Ann Thorac Surg. 2007;83(suppl):S769–S773
  16. Tagusari O, Ogino H, Kobayashi J, Bando K, Minatoya K, Sasaki H, et al. Should the transverse aortic arch be replaced simultaneously with aortic root replacement for annuloaortic ectasia in Marfan syndrome?. J Thorac Cardiovasc Surg. 2004;127:1373–1380
  17. Bachet J, Larrazet F, Goudot B, Dreyfus G, Folliguet T, Laborde F, et al. When should the aortic arch be replaced in Marfan patients?. Ann Thorac Surg. 2007;83(suppl):S774–S779
  18. Sakamoto I, Hayashi K, Yamaguchi T, Imada T. Growth rate of aortic diameter in patients with type B aortic dissection during the chronic phase. Circulation. 2004;110(suppl II):II256–II261
  19. Nollen GJ, Groenink M, Tijssen JGP, van der Wall EE, Mulder BJM. Aortic stiffness and diameter predict progressive aortic dilatation in patients with Marfan syndrome. Eur Heart J. 2004;25:1146–1152
  20. Tsai TT, Fattori R, Trimarchi S, Isselbacher E, Myrmel T, Evangelista A, et al. Long-term survival in patients presenting with type B acute aortic dissection: insights from the International Registry of Acute Aortic Dissection. Circulation. 2006;114:2226–2231
  21. Estrera AL, Miller CC, Goodrick J, Porat EE, Achouh PE, Dhareshwar J, et al. Update on outcomes of acute type B aortic dissection. Ann Thorac Surg. 2007;83(suppl):S842–S845
  22. Nienaber CA, Fattori R, Lund G, Dieckmann C, Wolf W, von Kodolitsch Y, et al. Nonsurgical reconstruction of thoracic aortic dissection by stent-graft placement. N Engl J Med. 1999;340:1539–1545
  23. Botta L, Russo V, Grigioni F, Arpesella G, Rocchi G, Di Bartolomeo R, et al. Unusual rapid evolution of type B aortic dissection in a Marfan patient following heart transplantation: successful endovascular treatment. Eur J Vasc Endovasc Surg. 2006;32:358–360
  24. Svensson LG, Crawford ES. Aortic dissection and aortic aneurysm surgery: clinical observations, experimental investigations, and statistical analyses; II. Curr Probl Surg. 1992;29:915–1007
  25. Umana JP, Miller DC, Mitchell RS. What is the best treatment for patients with acute type B aortic dissections–medical, surgical, or endovascular stent-grafting?. Ann Thorac Surg. 2002;74(suppl):S1840–S1843
  26. Ince H, Rehders TC, Petzsch M, Kische S, Nienaber CA. Stent-grafts in patients with Marfan syndrome. J Endovasc Surg. 2005;12:82–88
  27. Nataatmadja M, West J, West M. Overexpression of transforming growth factor-β is associated with increased hyaluronan content and impairment of repair in Marfan syndrome aortic aneurysm. Circulation. 2006;114(suppl 1):I371–I377
  28. Fattori R. Towards a better management of descending aortic dissection: the importance of close ambulatory follow-up. Eur J Vasc Endovasc Surg. 2006;32:356–357

 Disclosures: Rossella Fattori, MD, reports receiving consulting fees, lecture fees, or both from Medtronic.

PII: S0022-5223(09)00422-X

doi: 10.1016/j.jtcvs.2009.03.014

The Journal of Thoracic and Cardiovascular Surgery
Volume 138, Issue 5 , Pages 1108-1114 , November 2009

Article Tools

* Image Usage & Resolution