[Aortic valve preservation in Marfan syndrome. Initial experience].
OBJECTIVE
Preservation of the aortic valve using the technique described by David has been shown to be as effective as the Bentall-De Bono procedure. It avoids both the need for long-term anticoagulation and the complications associated with mechanical prostheses. We report our initial experience using this technique in patients with Marfan syndrome.


METHODS
Between April 2004 and April 2006, we used the David reimplantation technique in 40 patients with an aortic root aneurysm. Eighteen patients had Marfan syndrome. Their median age was 29 years (13-55 years). Echocardiography showed that the median diameter of the aortic sinus was 53 mm (46-59 mm).


RESULTS
In 17 patients, aortic valve preservation was possible. No patient died during hospitalization and there were no significant complications. On echocardiography at discharge, no patient had greater than grade-II aortic regurgitation. During a median follow-up period of 8 months (1-24 months), one patient died due to rupture of an abdominal aneurysm. The others are all in New York Heart Association class I.


CONCLUSIONS
Preservation of the aortic valve by means of valve reimplantation produced excellent results. It avoided both the thromboembolic and hemorrhagic complications associated with prostheses and the need for long-term anticoagulation. If reimplanted valves continue to function adequately over the long term, this technique should become the treatment of choice for aneurysms of the ascending aorta in patients with Marfan syndrome.
Forteza
Alberto
A
Servicio de Cirugía Cardiaca, Hospital Universitario 12 de Octubre, Madrid, Spain. aforteza.hdoc@salud.madrid.org
Cortina
Jose M
JM
Sánchez
Violeta
V
Centeno
Jorge
J
López
M Jesús
MJ
Pérez de la Sota
Enrique
E
Rufilanchas
Juan J
JJ
D000293:Adolescent; D000328:Adult; D001014:Aortic Aneurysm / Q000209:etiology / Q000601:surgery*; D001021:Aortic Valve; D006348:Cardiac Surgical Procedures / Q000379:methods*; D006801:Humans; D008382:Marfan Syndrome / Q000150:complications / Q000601:surgery*; D008875:Middle Aged; D016896:Treatment Outcome