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  • Title: Aortic surgery in Marfan patients with severe pectus excavatum.
    Author: Raffa GM, Kowalewski M, Malvindi PG, Bertani A, Romano G, Sciacca S, Turrisi M, Armaro A, Stringi V, Montalbano G, Mattiucci G, Follis F, Pilato M.
    Journal: J Cardiovasc Med (Hagerstown); 2017 May; 18(5):305-310. PubMed ID: 27136701.
    Abstract:
    AIMS: The optimal surgical management of the aortic root phenotype Marfan patients with severe pectus excavatum is a subject of debate. All the available literature were reviewed according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) principles in order to assess the early outcomes of both pectus excavatum and aortic repair techniques. METHODS: Searches were done in PubMed and MEDLINE electronic databases dating from July 1953 to December 2015. RESULTS: A total of 97 peer-reviewed publications were retrieved, and 27 relevant publications were identified with a total of 39 Marfan patients with pectus excavatum who underwent ascending aorta and aortic root surgery. Emergency acute Type-A aortic dissection repair was reported in five cases. Concomitant pectus excavatum and aortic root repair and composite graft implantation were the most commonly performed procedures. Complications after a staged or a combined approach were uncommon and no deaths occurred. CONCLUSION: Aortic surgery in Marfan patients with pectus excavatum was carried out according to a variety of strategies, surgical techniques and accesses with low complications rate and no mortality. Many of these were well tolerated with minimal complications and no mortality.
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