What is the current role of the valve-sparing procedure and also the role of the homograft aortic root for Marfan patients?
Although the valve-sparing procedures as popularized by Yacoub and David appear to have wide application in non-Marfan aortic root aneurysms, most surgeons performing aortic root replacement feel that Marfan disease is usually a contraindication to the valve-sparing procedure. This is because of concern about further enlargement of the aortic annulus in Marfan patients, and also recent findings by Fleischer, et al. from Johns Hopkins showing moderate-to-marked degeneration of the microfibular structure of the aortic valve; this microfibular fragmentation has been demonstrated using an immunofluorescent staining technique for fibrillin in excised aortic leaflets from Marfan patients. Although caution should be used at the pre sent time with regards to the valve-sparing procedure in Marfan patients, it is encouraging that this same fibrillin fragmentation is seen in mitral leaflets of Marfan patients, and yet, the long-term results with mitral valve annuloplasty in these patients has bee
Related Questions
- Should root replacement with aortic valve-sparing be offered to patients with bicuspid valves or severe aortic regurgitation?
- Should root replacement with aortic valve-sparing be offered to patients with bicuspid valves or severe aortic regurgitation?
- What is the current role of the valve-sparing procedure and also the role of the homograft aortic root for Marfan patients?
- What is the current thinking regarding the proper timing of aortic root replacement for Marfan patients?
- What is the current thinking regarding the proper timing of aortic root replacement for Marfan patients?
- What are the important features of late follow-up of Marfan patients undergoing aortic root replacement?
