Personalised external aortic root support (PEARS) to stabilise an aortic root aneurysm.

Marfan syndrome aortic root aneurysm personalised medicine prophylactic surgery

Journal

The British journal of cardiology
ISSN: 1753-4313
Titre abrégé: Br J Cardiol
Pays: England
ID NLM: 9503762

Informations de publication

Date de publication:
2020
Historique:
entrez: 24 6 2022
pubmed: 28 7 2020
medline: 28 7 2020
Statut: epublish

Résumé

Patients with congenitally determined aortic root aneurysms are at risk of aortic valve regurgitation, aortic dissection, rupture and death. Personalised external aortic root support (PEARS) may provide an alternative to aortic root replacement. This was a multi-centre, prospective cohort of all consecutive patients who received ExoVasc mesh implants for a dilated aortic root between 2004 and 2017. Baseline and peri-operative characteristics, as well as early postoperative outcomes are described, and time-related survival and re-operation free survival are estimated using the Kaplan-Meier method. From 2004 through 2017, 117 consecutive patients have received ExoVasc mesh implants for aortic root aneurysm. The inclusion criteria were an aortic root/sinus of Valsalva and ascending aorta with asymptomatic dilatation of between 40 and 50 mm in diameter in patients aged 16 years or more. Patients with more than mild aortic regurgitation were excluded. There was one early death. The length of stay was within seven days in 75% of patients. In conclusion, the operation achieves the objectives of valve-sparing root replacement. PEARS may be seen as a low-risk conservative operation, which can be applied earlier on in the disease process, and which is complementary to more invasive procedures, such as valve-sparing root replacement or total root replacement.

Identifiants

pubmed: 35747770
doi: 10.5837/bjc.2020.022
pii: bjc.2020.022
pmc: PMC9205243
doi:

Types de publication

Journal Article

Langues

eng

Pagination

22

Informations de copyright

Copyright © 2020 Medinews (Cardiology) Limited.

Déclaration de conflit d'intérêts

The only author with a potential conflict of interest is TJG who is the inventor of the device. He was the first patient to have this operation in 2004, and is a shareholder in Exstent Ltd., the company that manufactures the Personalised External Aortic Root Support (PEARS) ExoVasc device.

Références

Heart. 2012 Jan;98(1):65-8
pubmed: 22002977
Heart. 2014 Jun;100(12):908
pubmed: 24670419
N Engl J Med. 1972 Apr 13;286(15):804-8
pubmed: 5011789
Ann Thorac Surg. 2015 Apr;99(4):1464-6
pubmed: 25841843
J Thorac Cardiovasc Surg. 2015 Jan;149(1):9-11
pubmed: 25524667
Ann Thorac Surg. 2016 Dec;102(6):e499-e501
pubmed: 27847065
J Am Coll Cardiol. 1993 Nov 1;22(5):1470-6
pubmed: 8227807
Eur J Cardiothorac Surg. 2017 May 1;51(5):1021
pubmed: 28329398
Multimed Man Cardiothorac Surg. 2013;2013:mmt004
pubmed: 24413003
Heart. 2014 Jun;100(12):969-75
pubmed: 24395977
J Thorac Cardiovasc Surg. 2014 Jun;147(6):1758-66, 1767.e1-4
pubmed: 24655904
BMJ Open. 2012 Mar 02;2(2):e000725
pubmed: 22389361
Int J Cardiol. 2016 Oct 1;220:772-4
pubmed: 27393865
Heart. 2011 Jun;97(12):955-8
pubmed: 21228428
Eur Heart J. 2013 Jul;34(26):1947-9
pubmed: 23991439
J Mech Behav Biomed Mater. 2018 Feb;78:164-174
pubmed: 29156355
Ann Thorac Surg. 2007 Feb;83(2):S780-4; discussion S785-90
pubmed: 17257926
Interact Cardiovasc Thorac Surg. 2013 Aug;17(2):334-9
pubmed: 23624982
Eur Heart J. 2012 Oct;33(19):2451-96
pubmed: 22922415
Lancet. 2004 Oct 30-Nov 5;364(9445):1582
pubmed: 15519627
Eur J Cardiothorac Surg. 2017 May 1;51(5):1020
pubmed: 28329349
Heart. 2018 Mar;104(6):480-486
pubmed: 28780581
Eur J Cardiothorac Surg. 2015 Sep;48(3):502-5
pubmed: 25406424
Interact Cardiovasc Thorac Surg. 2017 Jul 1;25(1):89-95
pubmed: 28419245
Interact Cardiovasc Thorac Surg. 2010 Mar;10(3):360-5
pubmed: 20007995
Eur Heart J. 2017 Dec 01;38(45):3370-3377
pubmed: 29045647

Auteurs

John Pepper (J)

Consultant Cardiac Surgeon, Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, London, SW3 6NP.

Cemil Izgi (C)

Consultant Cardiac Radiologist, Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, London, SW3 6NP.

Tal J Golesworthy (TJ)

Chartered Energy Engineer, Extent Ltd., Theocsbury House, 18-20 Barton Street, Tewkesbury Gloucestershire.

Johanna J M Takkenberg (JJM)

Cardiac Epidemiologist, Erasmus University Medical Centre, PO Box 2040, 3000 CA Rotterdam The Netherlands.

Tom Treasure (T)

Consultant Cardiothoracic Surgeon, Clinical Operational Research Unit, University College London, 4 Taviton Street, London WC1H 0BT.

Classifications MeSH