Marfan's syndrome: natural history and long-term follow-up of cardiovascular involvement.
A retrospective analysis was undertaken to define the natural history and long-term follow-up of a group of patients with Marfan's syndrome. Eighty-four patients were diagnosed between January 1959 and June 1987 as having Marfan's syndrome; 68% were male; their ages ranged from 2 to 67 years (mean 26.6). Sixteen patients constituted the early surgical group (those who underwent surgery before 1979; mean age 36.1 years). Nineteen patients constituted the late surgical group (surgery in 1979 or later; mean age 33.3 years). The nonsurgical group comprised 49 patients (mean age 19.3 years). Fifty-seven percent of the patients had a diastolic murmur and 38% had cardiomegaly at presentation. Fifty-seven percent underwent cardiac catheterization, which revealed aortic root dilation (85%), aortic regurgitation (73%), aortic dissection (33%) and mitral regurgitation (36%). Thirteen of the 19 patients in the late surgical group received a composite graft repair of the ascending aorta as compared with only 2 of the 16 in the early surgical group. Follow-up information was obtained on 81 (96%) of 84 patients; the follow-up time was 2 to 332 months (mean 99). Thirty-one of the 81 patients died at age 3 to 63 years (mean age 35 years); 87% of the known causes of death were related to the cardiovascular system. Sixty-one percent of deaths were the result of aortic dissection or rupture or sudden cardiac death. Of the 50 survivors, 98%, including all patients in the late surgical group, were in functional class I or II. Overall survival at 5, 10 and 15 years after operation was 78.4%, 57.1% and 49.5%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Marsalese
D L
DL
Department of Cardiology, Cleveland Clinic Foundation, Ohio 44195-5066.
Moodie
D S
DS
Vacante
M
M
Lytle
B W
BW
Gill
C C
CC
Sterba
R
R
Cosgrove
D M
DM
Passalacqua
M
M
Goormastic
M
M
Kovacs
A
A
D000328:Adult; D000784:Aortic Dissection / Q000209:etiology*; D001014:Aortic Aneurysm / Q000209:etiology*; D006332:Cardiomegaly / Q000209:etiology*; D004108:Dilatation, Pathologic / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000209:etiology*; D006801:Humans; D008297:Male; D008382:Marfan Syndrome / Q000150:complications / Q000401:mortality* / Q000601:surgery; D012189:Retrospective Studies; D013997:Time Factors