Key result
In patients with Marfan syndrome, augmentation index (AIx@HR75) was significantly higher after composite valve grafting compared to those without surgery, indicating mildly altered arterial mechanical properties.
Why the study?
Does aortic root surgery (reimplantation or composite valve grafting) alter arterial mechanical properties in patients with Marfan syndrome compared to no surgery?
Case-Control (n=80)
Single-blind
No
Does aortic root surgery (reimplantation or composite valve grafting) alter arterial mechanical properties in patients with Marfan syndrome compared to no surgery?
Absolute Event Rate: 25.4% vs 14%
p-value: p=0.03
Aortic root surgery (reimplantation or conduit operation) in patients with Marfan syndrome only mildly alters arterial mechanical properties compared to no surgery.
May not substantially alter arterial stiffness after aortic root surgery in Marfan syndrome; leaves open impact on clinical outcomes.
Background: Alteration of arterial mechanical properties has adverse effects on cardiovascular disease in Marfan syndrome. Design: We compared central pulse pressure, augmentation index adjusted to a heart rate of 75 beats per minute (AIx@HR75) and pulse wave velocity in 25 Marfan patients who had under-gone an aortic valve-sparing reimplantation operation, in 15 Marfan patients after composite valve grafting operation, and in 40 age and sex-matched Mar-fan patients who had not undergone surgery. Results: Central pulse pressure, AIx@HR75 and pulse wave velocity were similar across all three patient groups. Exclusively AIx@HR75 was higher with conduit operations than in persons without any surgery (P = 0.03). Multivariate linear regression analysis documented association of AIx@HR75 with body height (P < 0.001) and with a history of aortic valve-sparing reimplantation operation (P < 0.001) or with a composite valve grafting operation (P = 0.006). Conclusions: Arterial mechanical properties are only mildly altered by surgery of the aortic root without difference between the reimplantation and conduit operation.
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Mortensen et al. (2012) conducted a case-control in Marfan syndrome (n=80). Composite valve grafting (CVG) or aortic valve-sparing reimplantation (AVR) vs. No aortic root surgery was evaluated on Augmentation index adjusted to a heart rate of 75 beats per minute (AIx@HR75) (p=0.03). In patients with Marfan syndrome, augmentation index (AIx@HR75) was significantly higher after composite valve grafting compared to those without surgery, indicating mildly altered arterial mechanical properties.
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