Van Hoof, L;
Rega, F;
Golesworthy, T;
Verbrugghe, P;
Austin, C;
Takkenberg, JJM;
Pepper, JR;
(2021)
Personalised external aortic root support for elective treatment of aortic root dilation in 200 patients.
Heart
10.1136/heartjnl-2021-319300.
(In press).
Preview |
Text
PEARS 200 V11 Heart R3 UNMARKED.pdf - Accepted Version Download (559kB) | Preview |
Abstract
BACKGROUND AND OBJECTIVES: In personalised external aortic root support (PEARS), a custom-made, macroporous mesh is used to stabilise a dilated aortic root and prevent dissection, primarily in patients with genetically driven aortopathies. Data are needed on the safety and postoperative incidence of aortic events. METHODS: We present a multicentre cohort study evaluating the first 200 consecutive patients (median age 33 years) undergoing surgery with an intention to perform PEARS for aortic root dilatation in 23 centres between 2004 and 2019. Perioperative outcomes were collected prospectively while clinical follow-up was retrieved retrospectively. Median follow-up was 21.2 months. RESULTS: The main indication was Marfan syndrome (73.5%) and the most frequent concomitant procedure was mitral valve repair (10%). An intervention for myocardial ischaemia or coronary injury was needed in 11 patients, 1 case resulting in perioperative death. No ascending aortic dissections were observed in 596 documented postoperative patient years. Late reoperation was performed in 3 patients for operator failure to achieve complete mesh coverage. Among patients with at least mild aortic regurgitation (AR) preoperatively, 68% had no or trivial AR at follow-up. CONCLUSIONS: This study represents the clinical history of the first 200 patients to undergo PEARS. To date, aortic dissection has not been observed in the restrained part of the aorta, yet long-term follow-up is needed to confirm the potential of PEARS to prevent dissection. While operative mortality is low, the reported coronary complications reflect the learning curve of aortic root surgery in patients with connective tissue disease. PEARS may stabilise or reduce aortic regurgitation.
| Type: | Article |
|---|---|
| Title: | Personalised external aortic root support for elective treatment of aortic root dilation in 200 patients |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/heartjnl-2021-319300 |
| Publisher version: | http://dx.doi.org/10.1136/heartjnl-2021-319300 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Aortic aneurysm, Marfan syndrome, pre-emptive, personalised, mesh, aortic dissection |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Dept of Mathematics UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Dept of Mathematics > Clinical Operational Research Unit |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10134109 |
Archive Staff Only
 |
View Item |
