Personalised external aortic root support (PEARS) in Marfan syndrome: Analysis of 1-9 year outcomes by intention-to-treat in a cohort of the first 30 consecutive patients to receive a novel tissue and valve-conserving procedure, compared with the published results of aortic root replacement

Heart

Volumn 100, Issue 12, 2014, Pages 969-975

  Treasure, Tom ^a   Takkenberg, Johanna J M ^b   Golesworthy, Tal ^c   Rega, Filip ^d   Petrou, Mario ^e   Rosendahl, Ulrich ^f   Mohiaddin, Raad ^f   Rubens, Michael ^f   Thornton, Warren ^c   Lees, Belinda ^f   Pepper, John ^f  

^a UNIVERSITY COLLEGE LONDON   (United Kingdom)

^b ERASMUS MEDICAL CENTER   (Netherlands)

^c Exstent Ltd   (United Kingdom)

^d UNIVERSITY HOSPITALS LEUVEN   (Belgium)

^e JOHN RADCLIFFE HOSPITAL   (United Kingdom)

^f ROYAL BROMPTON HOSPITAL   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ANGIOTENSIN II ANTAGONIST; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; NANOMESH; POLYMER;

ADOLESCENT; ADULT; ANGINA PECTORIS; AORTA DISEASE; AORTA DISSECTING ANEURYSM; AORTA VALVE REPLACEMENT; AORTIC ROOT SURGERY; ARTICLE; CARDIAC IMPLANT; CLINICAL ARTICLE; CLINICAL EFFECTIVENESS; COHORT ANALYSIS; COMPARATIVE EFFECTIVENESS; COMPUTER AIDED DESIGN; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; CORONARY ARTERY OBSTRUCTION; CORONARY STENT; CROSS-SECTIONAL STUDY; FEMALE; FOLLOW UP; HEART MUSCLE ISCHEMIA; HEART VENTRICLE FIBRILLATION; HUMAN; INTENTION TO TREAT ANALYSIS; INTERMETHOD COMPARISON; MALE; MARFAN SYNDROME; MECHANICAL HEART VALVE; MULTICENTER STUDY; OUTCOME ASSESSMENT; PATIENT SAFETY; PEROPERATIVE COMPLICATION; PERSONALISED EXTERNAL AORTIC ROOT SUPPORT; PRIORITY JOURNAL; PROSPECTIVE STUDY; SURGICAL TECHNIQUE; SURVIVAL RATE; SURVIVAL TIME;

ADULT; AORTIC ANEURYSM; AORTIC VALVE; BELGIUM; BLOOD VESSEL PROSTHESIS; BLOOD VESSEL PROSTHESIS IMPLANTATION; COMPUTER-AIDED DESIGN; FEMALE; FOLLOW-UP STUDIES; HEART VALVE PROSTHESIS IMPLANTATION; HUMANS; INDIVIDUALIZED MEDICINE; INTENTION TO TREAT ANALYSIS; LONDON; MAGNETIC RESONANCE ANGIOGRAPHY; MALE; MARFAN SYNDROME; PROSPECTIVE STUDIES; PROSTHESIS DESIGN; SURGERY, COMPUTER-ASSISTED; SURGICAL MESH; TIME FACTORS; TREATMENT OUTCOME; YOUNG ADULT;

EID: 84901592896     PISSN: 13556037     EISSN: 1468201X     Source Type: Journal    
DOI: 10.1136/heartjnl-2013-304913     Document Type: Article

References (30)

1. Vahanian A, Alfieri O, Andreotti F, et al. Guidelines on the management of valvular heart disease (version 2012). Eur Heart J 2012;33:2451-96.
2. Golesworthy T, Lamperth M, Mohiaddin R, et al. A jacket for the Marfan's aorta. Lancet 2004;364:1582.
3. Treasure T. The evolution of aortic root surgery for Marfan syndrome. Interact Cardiovasc Thorac Surg 2010;10:353-5.
4. Pepper J, Golesworthy T, Utley M, et al. Manufacturing and placing a bespoke support for the Marfan aortic root: description of the method and technical results and status at one year for the first ten patients. Interact Cardiovasc Thorac Surg 2010;10:360-5.
5. Pepper J, John CK, Gavino J, et al. External aortic root support for Marfan syndrome: early clinical results in the first 20 recipients with a bespoke implant. J R Soc Med 2010;103:370-5.
6. Treasure T, Crowe S, Chan KM, et al. A method for early evaluation of a recently introduced technology by deriving a comparative group from existing clinical data: a case study in external support of the Marfan aortic root. BMJ Open 2012;2:e000725.
7. Treasure T, Pepper J, Golesworthy T, et al. External aortic root support: NICE guidance. Heart 2012;98:65-8.
8. Benedetto U, Melina G, Takkenberg JJ, et al. Surgical management of aortic root disease in Marfan syndrome: a systematic review and meta-analysis. Heart 2011;97:955-8.
9. Treasure T, Pepper Jr. Aortic root surgery in Marfan syndrome. Heart 2011;97:951-2.
10. Pepper J, Petrou M, Rega F, et al. Implantation of an individually computer-designed and manufactured external support for the Marfan aortic root. http://mmctsoxfordjournals.org/cgi/content/full/mmt004?ijkey= WWjo5zbymFMuCWK&keytype=ref 2013
11. http://mmcts.oxfordjournals.org/content/2013/mmt004.full.pdf+html
12. Di Mario C, Pepper J, Golesworthy T, et al. External aortic root support for the Marfan aorta: anatomically normal coronary orifices imaged seven years after surgery. Interact Cardiovasc Thorac Surg 2012;15:528-30.
13. Treasure T, Golesworthy T, Pepper J, et al. Prophylactic surgery of the aortic root in Marfan Syndrome: reconsideration of the decision making process in the era of customised external aortic root support. J Vasc Endovasc Surg 2011;18:215-23.
14. Treasure T. CardioPulse: options for pre-emptive aortic root surgery for people with Marfan syndrome. Eur Heart J 2013;34:1947-9.
15. Shrestha M, Baraki H, Maeding I, et al. Long-term results after aortic valve-sparing operation (David I). Eur J Cardiothorac Surg 2012;41:56-61.
16. Treasure T. Options for pre-emptive aortic root surgery for people with Marfan syndrome. Eur Heart J 2013;34:1947-9.
17. Murdoch JL, Walker BA, Halpern BL, et al. Life expectancy and causes of death in the Marfan syndrome. N Engl J Med 1972;286:804-8.
18. Treasure T. Elective replacement of the aortic root in Marfan's syndrome. Br Heart J 1993;69:101-3. (Pubitemid 23056846)
19. Treasure T, Reynolds C, Valencia O, et al. The timing of aortic root replacement in the Marfan syndrome: computer aided decision support. In: Enker J. ed. Cardiac Surgery and Concomitant Disease. Darmstadt: Springer, 1999:91-8.
20. Treasure T, Chow T, Gallivan S. Replacement of the aortic root in Marfan's syndrome. N Engl J Med 1999;341:1473-4. (Pubitemid 29513469)
21. Treasure T. Cardiovascular surgery for Marfan syndrome. Heart 2000;84:674-8.
22. Kim SY, Martin N, Hsia EC, et al. Management of aortic disease in Marfan Syndrome: a decision analysis. Arch Intern Med 2005;165:749-55. (Pubitemid 40569427)
23. Robicsek F, Thubrikar MJ. Conservative operation in the management of annular dilatation and ascending aortic aneurysm. Ann Thorac Surg 1994;57:1672-4. (Pubitemid 24216355)
24. Bauer M, Grauhan O, Hetzer R. Dislocated wrap after previous reduction aortoplasty causes erosion of the ascending aorta. Ann Thorac Surg 2003;75:583-4. (Pubitemid 36184520)
25. Tanabe T, Kubo Y, Hashimoto M, et al. Wall reinforcement with highly porous Dacron mesh in aortic surgery. Ann Surg 1980;191:452-5. (Pubitemid 10135460)
26. Cohen O, Odim J, De la ZD, et al. Long-term experience of girdling the ascending aorta with Dacron mesh as definitive treatment for aneurysmal dilation. Ann Thorac Surg 2007;83:S780-4. (Pubitemid 46138056)
27. Verbrugghe P, Verbeken E, Pepper J, et al. External aortic root support: a histological and mechanical study in sheep. Interact Cardiovasc Thorac Surg 2013;17:334-9.
28. Neri E, Massetti M, Tanganelli P, et al. Is it only a mechanical matter? Histologic modifications of the aorta underlying external banding. J Thorac Cardiovasc Surg 1999;118:1116-18.
29. Treasure T, Pepper J. A call for expressions of interest in a comparative study of the options for pre-emptive aortic root surgery for people with Marfan syndrome. Eur J Cardiothorac Surg 2013;44:588.
30. Campbell M. Fabricated future: The sceptic's guide to 3D printing. New Scientist 2012;(2895):46-9.