PMID- 33447399
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220419
IS  - 2072-1439 (Print)
IS  - 2077-6624 (Electronic)
IS  - 2072-1439 (Linking)
VI  - 12
IP  - 12
DP  - 2020 Dec
TI  - Efficacy of cardiovascular surgery for Marfan syndrome patients: a single-center 
      15-year follow-up study.
PG  - 7106-7116
LID - 10.21037/jtd-20-2109 [doi]
AB  - BACKGROUND: Most Marfan syndrome (MFS) patients have thoracic aortic diseases 
      which is the major cause of death. The aim of the study is to analyze the impact 
      of different surgical procedures on prognosis of MFS patients. METHODS: We 
      retrospectively analyzed the results of hospitalization and long-term follow-up 
      of MFS patients who underwent surgical intervention in our center. RESULTS: Of 
      the 135 MFS patients, 11 died during hospitalization (8.1%). There were no 
      statistical differences in in-hospital mortality between the proximal surgery 
      group and the distal surgery group (P=0.11). Compared to patients who underwent 
      proximal aortic surgery, patients who underwent arch and distal surgery were more 
      likely to have postoperative respiratory dysfunction (P=0.008). The type of 
      surgical procedure was not associated with the incidence of complications during 
      hospitalization. Pre-surgical New York Heart Association (NYHA) Functional 
      Classification IV (P=0.047), EF <50% (P=0.047), pre-surgical atrial fibrillation 
      (P=0.042), and the injury of dissection propagating onto coronary arteries 
      (P=0.02) were independent risk factors for post-surgical mortality. After 15 
      years of follow-up, there were no deaths in the David group, while the 15-year 
      survival rate for patients in the Bentall group was 73%+/-13.5%, and 71%+/-13.9% for 
      patients in the arch surgery group (P=0.42). The probability of patients in the 
      David group not requiring re-surgery after 15 years was 58.9%+/-20%, while it was 
      58.7%+/-12.1% for patients in the Bentall group, 71.5%+/-10.5% for patients in the 
      Bentall + Arch group, and 12.5%+/-11.7% for patients in the Arch + Stent group 
      (P=0.007). CONCLUSIONS: The David procedure was the most beneficial and had the 
      highest long-term patient survival rates.
CI  - 2020 Journal of Thoracic Disease. All rights reserved.
FAU - Zhang, Boyao
AU  - Zhang B
AD  - Department of Cardiovascular Surgery, Changhai Hospital, Naval Medical University 
      (Second Military Medical University), Shanghai, China.
FAU - Xue, Qing
AU  - Xue Q
AD  - Department of Cardiovascular Surgery, Changhai Hospital, Naval Medical University 
      (Second Military Medical University), Shanghai, China.
FAU - Tang, Yangfeng
AU  - Tang Y
AD  - Department of Cardiovascular Surgery, Changhai Hospital, Naval Medical University 
      (Second Military Medical University), Shanghai, China.
FAU - Yu, Shangyi
AU  - Yu S
AD  - Department of Cardiovascular Surgery, Changhai Hospital, Naval Medical University 
      (Second Military Medical University), Shanghai, China.
FAU - Fan, Xingli
AU  - Fan X
AD  - Department of Cardiovascular Surgery, Changhai Hospital, Naval Medical University 
      (Second Military Medical University), Shanghai, China.
FAU - Xu, Zhiyun
AU  - Xu Z
AD  - Department of Cardiovascular Surgery, Changhai Hospital, Naval Medical University 
      (Second Military Medical University), Shanghai, China.
FAU - Han, Lin
AU  - Han L
AD  - Department of Cardiovascular Surgery, Changhai Hospital, Naval Medical University 
      (Second Military Medical University), Shanghai, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - J Thorac Dis
JT  - Journal of thoracic disease
JID - 101533916
PMC - PMC7797851
OTO - NOTNLM
OT  - Marfan syndrome (MFS)
OT  - aortic dissection
OT  - cardiovascular surgery
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at http://dx.doi.org/10.21037/jtd-20-2109). The authors have no 
      conflicts of interest to declare.
EDAT- 2021/01/16 06:00
MHDA- 2021/01/16 06:01
PMCR- 2020/12/01
CRDT- 2021/01/15 06:01
PHST- 2021/01/15 06:01 [entrez]
PHST- 2021/01/16 06:00 [pubmed]
PHST- 2021/01/16 06:01 [medline]
PHST- 2020/12/01 00:00 [pmc-release]
AID - jtd-12-12-7106 [pii]
AID - 10.21037/jtd-20-2109 [doi]
PST - ppublish
SO  - J Thorac Dis. 2020 Dec;12(12):7106-7116. doi: 10.21037/jtd-20-2109.