Follow-up echocardiographic data were available for 88% of patients at discharge and 57% of patients at midterm. Mitral regurgitation was improved at discharge in 76%

of patients and at mid-term follow-up in 67% of patients. Independent predictors of improved mitral regurgitation were lesser degrees of preoperative tricuspid regurgitation or prebypass mitral regurgitation, absence of cerebrovascular disease, and lower left ventricular ejection fraction. Postoperatively, 89% of patients were New York Heart Association Class I or II Symptom; No reoperations for mitral regurgitation were performed. Survival was 68% at 5 years and Buparlisib in vivo 42% at 10 years. Independent predictors of late mortality were increasing age, diabetes, dialysis-dependent renal failure, and increased tricuspid regurgitation severity. The survival of 91 patients from this cohort did not differ from case-matched patients without mitral regurgitation

undergoing aortic valve replacement (P = .33).

Conclusion: Moderate functional mitral regurgitation improved in most patients after aortic valve replacement. Residual mitral GDC0449 regurgitation did not affect survival independently of left ventricular function.”
“Objective: A prospective, international registry study was initiated to provide contemporary comparative data on short-term clinical outcomes after aortic valve-sparing and aortic valve-replacing root operations in patients with Marfan syndrome. The purpose of this initial report is to describe the study design and to compare early outcomes in the first 151 enrolled patients.

Methods: We assessed 30-day outcomes in 151 patients who met strict Ghent diagnostic criteria for Marfan syndrome and underwent aortic root replacement with either valve-replacing (n = 46) or valve-sparing techniques (n = 105) at one of 18 participating centers. In the valve replacement group, a mechanical composite valve graft was used in 39 (85%) patients and a bioprosthetic valve in 7 (15%). In the valve-sparing group, David V procedures were performed in 57 (54%) patients, David I in 38 (36%), David IV in 8 (8%), Florida sleeve in 1 (1%), and Yacoub click here remodeling in 1 (1%).

Results:

No in-hospital or 30-day deaths occurred. Despite longer crossclamp and cardiopulmonary bypass times in the valve-sparing group, there were no significant between-group differences in postoperative complications. Thirty-day valve-related complications occurred in 2 (4%) patients undergoing valve replacement and in 3 (3%) undergoing valve-sparing procedures (P = .6).

Conclusions: The analysis of early outcomes revealed that valve-sparing techniques were the most common approach to root replacement in patients with Marfan syndrome in these centers. The complexity of valve-sparing root replacement did not translate into any demonstrable adverse early outcomes. Subsequent analysis will compare the 3-year durability of these two surgical approaches.