P309. Size and Morphological Differences of Thoracic Cage in Marfan vs Non-Marfan patients
Presented During: POD Abstracts (Available for viewing in the exhibit hall for the duration of the meeting)
Kyoto University, Graduate School of Medicine
Kyoto-shi, Fukuoka
Japan - Contact Me
Medical School (6 years): MD (2013) - Kyoto University, Kyoto, Japan
Graduate School (2022-): PhD candidate – Kyoto University Graduate School of
Medicine, Japan
Residency (2013-2016): General/Cardiovascular Surgery - Kyoto University
Hospital, Kyoto, Japan
Fellowship (2016-2022): Cardiovascular Surgery - Kokura Memorial Hospital,
Fukuoka, Japan
Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square
Room: Central Park
Description
Objectives: Understanding thoracic cage morphology is essential for determining the optimal surgical incisions and approaches for thoracic aortic surgeries. We aimed to describe the size and morphological differences of the thoracic cage between Marfan and non-Marfan patients.
Methods: In this single-center retrospective cohort study, 58 Marfan patients and 1,535 non-Marfan patients diagnosed with aortic diseases were listed. Among these, 47 patients from each group were selected after exact matching to control for differences in sex and age categories. We compared physical data and computed tomography measurements of the thoracic cage between the two groups. Linear regression models were applied to estimate the effect size for Marfan syndrome patients in comparison to those without Marfan syndrome. The adjusted effect size was estimated using multiple linear regression models that accounted for sex, age, and body surface area.
Results: The Marfan group exhibited significantly greater height (Marfan: 177.1 ± 10.7 cm vs Non-Marfan: 166.3 ± 12.1 cm; P<0.001) and a significantly lower body mass index than the Non-Marfan group (Marfan: 22.3 ± 3.4 vs Non-Marfan: 20.0 ± 3.6; P=0.002). Angles between the ribs and the craniocaudal axis were significantly smaller in the Marfan group than in the non-Marfan group (45.0° vs 55.4° for the 4th rib; 42.2° vs 51.3° for the 5th rib; 39.7° vs 49.3° for the 6th rib; all P<0.001). At the level of the aortic valve, the adjusted analysis showed the Marfan group had significantly smaller anteroposterior distance, sternum-vertebra distance, transverse distance, and thoracic cavity area in comparison to the Non-Marfan group (Table). Furthermore, the angles between the ribs and the craniocaudal axis were significantly smaller in the Marfan group than in the Non-Marfan group in both crude and adjusted analyses. The angles between the ribs and the craniocaudal axis showed a mild correlation with the anteroposterior distance and the sternum-vertebra distance at the level of the aortic arch (R=0.22-0.34; all P<0.05), and a moderate correlation with those at the level of the aortic valve (R=0.46-0.54; all P<0.001).
Conclusions: Our findings implicate that patients with Marfan syndrome exhibit a flatter chest wall than those without Marfan syndrome. Better results may be obtained if these morphological differences are taken into account in the surgical strategy.
Authors
Yuki Kuroda (1), Takehiko Matsuo (1), Hiroaki Osada (1), Masahide Kawatou (1), Takahide Takeda (1), Fumie Takai (1), Kazuhiro Takatoku (1), Hiromasa Kira (1), Yasuyuki Fujimoto (1), Haruka Fujimoto (1), Kazuyoshi Kanno (1), Tadashi Ikeda (1), Kenji Minatoya (1)
Institutions
(1) Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Methods: In this single-center retrospective cohort study, 58 Marfan patients and 1,535 non-Marfan patients diagnosed with aortic diseases were listed. Among these, 47 patients from each group were selected after exact matching to control for differences in sex and age categories. We compared physical data and computed tomography measurements of the thoracic cage between the two groups. Linear regression models were applied to estimate the effect size for Marfan syndrome patients in comparison to those without Marfan syndrome. The adjusted effect size was estimated using multiple linear regression models that accounted for sex, age, and body surface area.
Results: The Marfan group exhibited significantly greater height (Marfan: 177.1 ± 10.7 cm vs Non-Marfan: 166.3 ± 12.1 cm; P<0.001) and a significantly lower body mass index than the Non-Marfan group (Marfan: 22.3 ± 3.4 vs Non-Marfan: 20.0 ± 3.6; P=0.002). Angles between the ribs and the craniocaudal axis were significantly smaller in the Marfan group than in the non-Marfan group (45.0° vs 55.4° for the 4th rib; 42.2° vs 51.3° for the 5th rib; 39.7° vs 49.3° for the 6th rib; all P<0.001). At the level of the aortic valve, the adjusted analysis showed the Marfan group had significantly smaller anteroposterior distance, sternum-vertebra distance, transverse distance, and thoracic cavity area in comparison to the Non-Marfan group (Table). Furthermore, the angles between the ribs and the craniocaudal axis were significantly smaller in the Marfan group than in the Non-Marfan group in both crude and adjusted analyses. The angles between the ribs and the craniocaudal axis showed a mild correlation with the anteroposterior distance and the sternum-vertebra distance at the level of the aortic arch (R=0.22-0.34; all P<0.05), and a moderate correlation with those at the level of the aortic valve (R=0.46-0.54; all P<0.001).
Conclusions: Our findings implicate that patients with Marfan syndrome exhibit a flatter chest wall than those without Marfan syndrome. Better results may be obtained if these morphological differences are taken into account in the surgical strategy.
Authors
Yuki Kuroda (1), Takehiko Matsuo (1), Hiroaki Osada (1), Masahide Kawatou (1), Takahide Takeda (1), Fumie Takai (1), Kazuhiro Takatoku (1), Hiromasa Kira (1), Yasuyuki Fujimoto (1), Haruka Fujimoto (1), Kazuyoshi Kanno (1), Tadashi Ikeda (1), Kenji Minatoya (1)
Institutions
(1) Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Presentation Duration
PODS will be on display in the exhibit hall for the duration of the meeting during exhibit hall hours. PODS will also be available for viewing on the meeting website. There is no formal presentation associated with your POD, but we encourage you to visit the PODS area during breaks to connect with those viewing.