Valve-sparing aortic root replacement (David I procedure) in Marfan disease: single-centre 20-year experience in more than 100 patients†

Martens, Andreas; Beckmann, Erik; Kaufeld, Tim; Fleißner, Felix; Neuser, Julia; Korte, Wilhelm; Merz, Constanze; Krueger, Heike; Haverich, Axel; Shrestha, Malakh

doi:10.1093/ejcts/ezy300

Cited by 33 publications

(22 citation statements)

References 15 publications

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“…With no in-hospital mortality and only one patient undergoing re-operation of the aortic root during follow-up, our excellent results are comparable to recent reports 5,8,11,14 . In one of the longest published cohort studies, Martens et al .…”

Section: Discussionsupporting

confidence: 87%

“…During follow-up, no case of valvular endocarditis, or any adverse neurological events were recorded, which is in good standing with current literature 5,8 . Noteworthy is the observation that patients with MFS tend to develop at least one episode of postoperative blood-culture negative fever, without elevation of infectious parameters.…”

Section: Discussionsupporting

confidence: 85%

“…In one of the longest published cohort studies, Martens et al . reported freedom of re-operation rates of 86% at 10 years and 80% at 20 years, in a single-center series of 104 MFS patients 8 . Kari et al .…”

Section: Discussionmentioning

confidence: 98%

“…The aortic valve-sparing reimplantation technique first described by David and Feindel 3 was originally developed as an aortic valve-sparing operation for patients with aortic valve incompetence and aneurysm of the ascending aorta 4 . Today, prophylactic replacement of the dilated aortic root with preservation of the native aortic valve leads to excellent results, allowing an almost normal life-expectancy, avoiding the need of lifelong anticoagulation, especially for younger patients with MFS 5–8 .…”

Section: Introductionmentioning

confidence: 99%

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The reimplantation valve-sparing aortic root replacement technique for patients with Marfan syndrome: A single-center experience

Kremer

Farag

Zaradzki

et al. 2019

Sci Rep

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Valve-sparing aortic root replacement (VSARR) through reimplantation technique is widely regarded as optimal surgical approach for Marfan syndrome (MFS) patients. Perioperative and long-term data from all MFS patients undergoing VSARR using David’s technique at our center from 2007–2018 were analyzed. We included 56 patients with a mean age of 32.3 ± 12.3 years. Logistic EuroSCORE was 7.96 ± 5.2. Among others concomitant surgical procedures included aortic arch surgery (8.9%), mitral valve repair (23.2%) and replacement (1.7%). There were no operative deaths, nor in-hospital-mortality. One patient underwent re-exploration for bleeding, dialysis and pacemaker implantation was required in one case each. There was no occurrence of low-output syndrome nor neurological complications. Significant gender differences were not found, except for intraoperative blood transfusion occurring significantly more often in the female gender (p = 0.009). Despite significantly longer procedural times, concomitant surgery did not negatively impact overall outcome. Freedom of reoperation of the aortic root was 100% at 1 year, 97.7% at 8 years. Until last follow-up (61 ± 38 month) all patients survived, with no evidence of endocarditis. We emphasize once more that VSARR using David’s procedure is a safe method for MFS patients with excellent long-term results even if concomitant procedures are performed.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The reimplantation valve-sparing aortic root replacement technique for patients with Marfan syndrome: A single-center experience

Kremer

Farag

Zaradzki

et al. 2019

Sci Rep

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“…If the patients have a family history of aortic rupture, or increase in aortic diameter exceeding 1 cm/year, earlier surgical intervention is recommended. Various surgical procedures have been offered, including various valve sparing procedures which preserve the native aortic valve and eliminate the need for long-term anticoagulation [32][33][34]. When mechanical valve replacement is performed, long-term anticoagulation with coumadin is required.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic Management of an Adolescent With Marfan Syndrome During Anterior Spinal Fusion

et al. 2018

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Marfan syndrome (MFS) is an autosomal dominant disorder resulting from a mutation of the gene encoding fibrillin-1 (FBN1) on chromosome 15. Fibrillin-1 is a matrix glycoprotein essential for the formation of microfibrils that regulate the formation and repair of connective tissue throughout the body. This primary cellular defect results in a multisystem disorder of connective tissue. Given the multisystem involvement of MFS, anesthetic care is frequently required during surgical or orthopedic procedures. We present a 15-year-old adolescent who required anesthetic care during spinal fusion. The perioperative implications of MFS are reviewed and options for anesthetic care presented.

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A Systematic Analysis of Additive Manufacturing Techniques in the Bioengineering of In Vitro Cardiovascular Models

Mohanadas,

Nair,

Doctor

et al. 2023

Ann Biomed Eng

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Additive Manufacturing is noted for ease of product customization and short production run cost-effectiveness. As our global population approaches 8 billion, additive manufacturing has a future in maintaining and improving average human life expectancy for the same reasons that it has advantaged general manufacturing. In recent years, additive manufacturing has been applied to tissue engineering, regenerative medicine, and drug delivery. Additive Manufacturing combined with tissue engineering and biocompatibility studies offers future opportunities for various complex cardiovascular implants and surgeries. This paper is a comprehensive overview of current technological advancements in additive manufacturing with potential for cardiovascular application. The current limitations and prospects of the technology for cardiovascular applications are explored and evaluated.

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Valve-sparing aortic root replacement (David I procedure) in Marfan disease: single-centre 20-year experience in more than 100 patients†

Cited by 33 publications

References 15 publications

The reimplantation valve-sparing aortic root replacement technique for patients with Marfan syndrome: A single-center experience

The reimplantation valve-sparing aortic root replacement technique for patients with Marfan syndrome: A single-center experience

Anesthetic Management of an Adolescent With Marfan Syndrome During Anterior Spinal Fusion

A Systematic Analysis of Additive Manufacturing Techniques in the Bioengineering of In Vitro Cardiovascular Models

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