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You are here: Contents > 2014 > Volume 23 Number 4 July 2014 > AORTIC VALVE DISEASE > Surgical Reconstruction of Aortic Root in Marfan Syndrome Patients: A Systematic Review

Surgical Reconstruction of Aortic Root in Marfan Syndrome Patients: A Systematic Review

Rui Hu, Zhiwei Wang, Xiaoping Hu, Hongbing Wu, Zhiyong Wu, Zhen Zhou

Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, China

Background and aim of the study: Several recent studies have compared the clinical results of valvesparing (VS) surgery and composite valve graft (CVG) surgery in the aortic root reconstruction of Marfan syndrome (MS) patients. The study aim was to investigate whether it is appropriate to preserve the native aortic valve in root surgery of MFS patients when taking the short-term and long-term prognoses into consideration.

Method: A thorough literature search of PubMed, Embase and Cochrane library was conducted to identify studies comparing the outcomes of VS and CVG surgery in MFS patients. The Newcastle-Ottawa Scale evaluation scheme was used to assess the methodological quality of the included articles. Data were extracted from reports and analyzed using Revman 5.0, supplied by Cochrane collaboration.

Result: Six clinical trials incorporating 539 patients were

included. Compared to CVG, VS surgery was associated with a lower risk for re-exploration (RR 0.48, 95% CI 0.24-0.97; p = 0.04), thromboembolic events (RR 0.17, 95% CI 0.05-0.57; p = 0.004) and endocarditis (RR 0.31, 95% CI 0.11-0.94; p = 0.04). Despite an inherent incidence of aortic regurgitation, VS surgery resulted in an elevation of long-term survival rate; however, no statistical differences were found between groups with regards to reoperation (RR 1.07, 95% CI 0.35-3.27; p = 0.91).

Conclusion: Root reconstruction with VS surgery can effectively improve the prognosis of MFS patients and provide a promising alternative for surgical treatment. However, the results must be interpreted with caution due to the retrospective nature of the included studies; large-scale prospective control trials are needed to confirm these findings.

The Journal of Heart Valve Disease 2014;23:473-483

Surgical Reconstruction of Aortic Root in Marfan Syndrome Patients: A Systematic Review

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