The following is a summary of “Risk profile and operative outcomes in patients with and without Marfan syndrome undergoing thoracoabdominal aortic aneurysm repair,” published in the December 2023 issue of Surgery by Christopher Lau, et al.

For a study, researchers sought to find out how well people with and without Marfan syndrome did during surgery and in the long run after having a thoracoabdominal aortic aneurysm repaired. They found all the patients with a thoracoabdominal aortic aneurysm repaired between 1997 and 2022. The main result was a collection of big bad events. Long-term mortality and problems in individuals were secondary results. It was done to use the inverse chance of treatment ranking. Weighted Kaplan-Meier models were used to determine how long people would live. 

Multivariable research found factors that were linked to big bad events. 684 people had open thoracoabdominal aortic aneurysm repair. Ninety (13.1%) had Marfan syndrome, but 594 (86.1%) did not. They were 46 years old (range: 36–56 years) compared to 69 years old (range: 61–76 years); P <.001. There were more type I or III chronic dissections (77 of 90; 85.3%) and extent II or III aneurysms (57 of 90; 63.3% vs. 211 out of 594; 35.6%; P <.001). Heart disease risk factors were less common in people with Marfan syndrome. Major bad events were the same in both groups (12 out of 90, or 13.3%, vs. 100 out of 594, or 16.8%); P =.49. 

There was no difference in the number of people who died during surgery (3 out of 90, or 3.3%, vs. 28 out of 594, or 4.7%; P =.75). Survival at 10 years without giving it any weight was 78.7% vs 46.8% (P =.001). It was found that there was no change in long-term mortality (adjusted hazard ratio, 0.79; 95% CI, 0.32-1.99; P =.62; Log-rank P =.12). Urgent/emergency procedures (odds ratio, 2.17; 95% CI, 1.35–3.48; P <.01) and kidney failure (odds ratio, 2.29; 95% CI, 1.43–3.68; P <.01) were linked to major adverse events, but Marfan syndrome was not (odds ratio, 1.56; 95% CI, 0.69–3.49; P =.28). Even though the risks are different, open thoracoabdominal aortic aneurysm treatment can be done on people with and without Marfan syndrome with similar results. Surgical and postoperative plans must be customized to meet each patient’s unique needs for the best results.

Source: sciencedirect.com/science/article/abs/pii/S0022522323003215