A Comparative Analysis of Perioperative and Long-term Outcomes in Marfan Syndrome Patients Undergoing Open Thoracoabdominal Aortic Aneurysm Repair
Presented During:
Thursday, April 25, 2024: 5:38PM - 7:00PM
Sheraton Times Square
Posted Room Name:
Central Park
Abstract No:
P0007
Submission Type:
Abstract Submission
Authors:
Luchen Wang (1), Yanxiang Liu (1), Xiaogang Sun (1)
Institutions:
(1) Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Xicheng
Submitting Author:
Luchen Wang
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Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
Co-Author(s):
Yanxiang Liu
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Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
Xiaogang Sun
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Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
Presenting Author:
Luchen Wang
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Abstract:
Objectives: A consensus on surveillance for the thoracoabdominal aortic aneurysm (TAAA) in patients with Marfan syndrome (MFS) has not been established. This study aimed to compare the perioperative and long-term outcomes after open TAAA repair in patients with and without MFS.
Methods: This retrospective study included 230 consecutive patients who underwent TAAA repair from 2012 to 2022. We compared 69 MFS patients with 161 non-MFS patients. The primary endpoints were composite adverse events and long-term survival, encompassing 30-day mortality, persistent stroke, persistent paraplegia, and acute renal failure requiring continuous dialysis. The secondary outcome was the re-operation rate. Multivariate analysis was used to identify factors associated with major adverse events and reoperation.
Results: MFS patients were younger than non-MFS patients (31.9±8.5 vs 44.8±12.3 years; P<0.001) and underwent more Crawford extent III repairs (56.5% vs 34.8%; P=0.002). No significant difference in major adverse events was found between groups (10.1% in MFS vs 13.0% in non-MFS; P=0.538). The reoperation rate was significantly higher in the MFS group than in the non-MFS group (18.8% vs 5.0%; P<0.001). Overall survival was significantly superior in the MFS group than in the non-MFS group (Log-rank P=0.046). Multivariable analysis revealed age ≥50 years (OR 4.08, 95%CI: 1.62-10.27; P=0.003), Crawford II repair (OR 5.68, 95%CI: 1.12-28.78; P=0.036), and Crawford III repair (OR 9.76, 95%CI: 2.01-47.27; P=0.005) were associated with major adverse events, while MFS was not.
Conclusions: Open TAAA repair in MFS patients, despite different risk profiles, can achieve similar or even superior operative outcomes compared to non-MFS patients. Surgical approaches and adjunctive techniques should be individualized to meet the specific needs of each patient to optimize outcomes.
Methods: This retrospective study included 230 consecutive patients who underwent TAAA repair from 2012 to 2022. We compared 69 MFS patients with 161 non-MFS patients. The primary endpoints were composite adverse events and long-term survival, encompassing 30-day mortality, persistent stroke, persistent paraplegia, and acute renal failure requiring continuous dialysis. The secondary outcome was the re-operation rate. Multivariate analysis was used to identify factors associated with major adverse events and reoperation.
Results: MFS patients were younger than non-MFS patients (31.9±8.5 vs 44.8±12.3 years; P<0.001) and underwent more Crawford extent III repairs (56.5% vs 34.8%; P=0.002). No significant difference in major adverse events was found between groups (10.1% in MFS vs 13.0% in non-MFS; P=0.538). The reoperation rate was significantly higher in the MFS group than in the non-MFS group (18.8% vs 5.0%; P<0.001). Overall survival was significantly superior in the MFS group than in the non-MFS group (Log-rank P=0.046). Multivariable analysis revealed age ≥50 years (OR 4.08, 95%CI: 1.62-10.27; P=0.003), Crawford II repair (OR 5.68, 95%CI: 1.12-28.78; P=0.036), and Crawford III repair (OR 9.76, 95%CI: 2.01-47.27; P=0.005) were associated with major adverse events, while MFS was not.
Conclusions: Open TAAA repair in MFS patients, despite different risk profiles, can achieve similar or even superior operative outcomes compared to non-MFS patients. Surgical approaches and adjunctive techniques should be individualized to meet the specific needs of each patient to optimize outcomes.
Aortic Symposium:
Descending/Thoracoabdominal Aorta
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