PMID- 26794897
OWN - NLM
STAT- MEDLINE
DCOM- 20160801
LR  - 20160322
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 101
IP  - 4
DP  - 2016 Apr
TI  - Midterm Survival and Quality of Life After Extent II Thoracoabdominal Aortic 
      Repair in Marfan Syndrome.
PG  - 1402-9; discussion 1409
LID - S0003-4975(15)01678-1 [pii]
LID - 10.1016/j.athoracsur.2015.10.018 [doi]
AB  - BACKGROUND: Pathologic conditions of the aorta remain a major source of morbidity 
      and mortality for patients with Marfan syndrome (MFS). Extensive thoracoabdominal 
      aortic aneurysm (TAAA) repair can prevent aortic catastrophe but carries 
      substantial risk of perioperative adverse events. We evaluated midterm survival 
      and quality of life (QoL) after contemporary Crawford extent II TAAA repair in 
      patients with MFS. METHODS: From 2004 to 2010, 49 consecutive patients with MFS 
      (mean age, 43.4 +/- 12.0 years) underwent extent II TAAA repair (41 elective and 8 
      urgent/emergent procedures) with intercostal reimplantation. Thirty-six patients 
      (73%) had aorta-related symptoms, and 45 (92%) had distal aortic dissection. 
      Operative adjuncts included cerebrospinal fluid drainage (n = 47 [96%]), left 
      heart bypass (n = 46 [94%]), and cold renal perfusion (n = 47 [96%]). 
      Kaplan-Meier survival analysis was performed. QoL was assessed in 24 patients 
      with a 12-item survey (12-Item Short Form Health Survey version 2 [SF-12v2]) a 
      median of 5.3 (interquartile range [IQR], 4.0-7.9) years postoperatively. QoL 
      data were normalized and compared with data from the general population. RESULTS: 
      There were no operative deaths, strokes, paraparesis, or paraplegia. Two patients 
      (4%) had permanent renal failure necessitating hemodialysis. The most frequent 
      complication was vocal cord paralysis (n = 21 [43%]). Six-year Kaplan-Meier 
      survival was 84% +/- 6%. The 24 patients with QoL data had slightly worse physical 
      component scores (46.0 +/- 10.6) and slightly better mental component scores (51.4 
      +/- 10.4) than the general population (50 +/- 10 for both scores). CONCLUSIONS: 
      Operative treatment of extensive TAAA in patients with MFS enables excellent 
      midterm survival and QoL. Cerebrospinal fluid drainage, left heart bypass, and 
      cold renal perfusion probably aid in achieving excellent outcomes.
CI  - Copyright (c) 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Ghanta, Ravi K
AU  - Ghanta RK
AD  - Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, 
      Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, 
      Texas Heart Institute, Houston, Texas; CHI St. Luke's Health-Baylor St. Luke's 
      Medical Center, Houston, Texas; Division of Thoracic and Cardiovascular Surgery, 
      University of Virginia, Charlottesville, Virginia.
FAU - Green, Susan Y
AU  - Green SY
AD  - Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, 
      Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, 
      Texas Heart Institute, Houston, Texas.
FAU - Price, Matt D
AU  - Price MD
AD  - Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, 
      Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, 
      Texas Heart Institute, Houston, Texas.
FAU - Arredondo, Courtney C
AU  - Arredondo CC
AD  - Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, 
      Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, 
      Texas Heart Institute, Houston, Texas.
FAU - Wainwright, D'Arcy
AU  - Wainwright D
AD  - Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, 
      Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, 
      Texas Heart Institute, Houston, Texas.
FAU - Preventza, Ourania
AU  - Preventza O
AD  - Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, 
      Baylor College of Medicine, Houston, Texas; Cardiovascular Research Institute, 
      Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, 
      Texas Heart Institute, Houston, Texas; CHI St. Luke's Health-Baylor St. Luke's 
      Medical Center, Houston, Texas.
FAU - de la Cruz, Kim I
AU  - de la Cruz KI
AD  - Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, 
      Baylor College of Medicine, Houston, Texas; Cardiovascular Research Institute, 
      Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, 
      Texas Heart Institute, Houston, Texas; CHI St. Luke's Health-Baylor St. Luke's 
      Medical Center, Houston, Texas.
FAU - Aftab, Muhammad
AU  - Aftab M
AD  - Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, 
      Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, 
      Texas Heart Institute, Houston, Texas; CHI St. Luke's Health-Baylor St. Luke's 
      Medical Center, Houston, Texas.
FAU - LeMaire, Scott A
AU  - LeMaire SA
AD  - Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, 
      Baylor College of Medicine, Houston, Texas; Cardiovascular Research Institute, 
      Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, 
      Texas Heart Institute, Houston, Texas; CHI St. Luke's Health-Baylor St. Luke's 
      Medical Center, Houston, Texas. Electronic address: slemaire@bcm.edu.
FAU - Coselli, Joseph S
AU  - Coselli JS
AD  - Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, 
      Baylor College of Medicine, Houston, Texas; Cardiovascular Research Institute, 
      Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, 
      Texas Heart Institute, Houston, Texas; CHI St. Luke's Health-Baylor St. Luke's 
      Medical Center, Houston, Texas.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20160113
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aortic Aneurysm, Thoracic/etiology/*mortality/*surgery
MH  - *Blood Vessel Prosthesis Implantation
MH  - Female
MH  - Humans
MH  - Male
MH  - Marfan Syndrome/*complications/mortality/surgery
MH  - Middle Aged
MH  - *Quality of Life
MH  - Retrospective Studies
MH  - Survival Analysis
MH  - Survival Rate
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2016/01/23 06:00
MHDA- 2016/08/02 06:00
CRDT- 2016/01/23 06:00
PHST- 2015/01/28 00:00 [received]
PHST- 2015/08/27 00:00 [revised]
PHST- 2015/10/09 00:00 [accepted]
PHST- 2016/01/23 06:00 [entrez]
PHST- 2016/01/23 06:00 [pubmed]
PHST- 2016/08/02 06:00 [medline]
AID - S0003-4975(15)01678-1 [pii]
AID - 10.1016/j.athoracsur.2015.10.018 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2016 Apr;101(4):1402-9; discussion 1409. doi: 
      10.1016/j.athoracsur.2015.10.018. Epub 2016 Jan 13.