P007. A Comparative Analysis of Perioperative and Long-term Outcomes in Marfan Syndrome Patients Undergoing Open Thoracoabdominal Aortic Aneurysm Repair
Presented During: POD Abstracts (Available for viewing in the exhibit hall for the duration of the meeting)
Fuwai Hospital, National Center for Cardiovascular Diseases
Beijing, Beijing
China - Contact Me
Luchen Wang is a Ph.D. degree student in the department of Vascular Surgery at Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College. His main research interests include the prognosis of surgical treatment of aortic disease and the investigation of biomarkers related to diagnostic markers or therapeutic targets of aortic disease.
Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square
Room: Central Park
Description
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.
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
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.
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
Presentation Duration
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