Treasure T
Br Heart J. 1993 Feb;69(2):101-3. doi: 10.1136/hrt.69.2.101.
We offer elective aortic replacement ot those we regard as being at high risk. The aortic root dimension and its rate of increase are the best predictors we have. We regard 5.5 cm as the probable upper limit and we are inclined to advocate surgery at an earlier stage in high risk families and in women planning pregnancy. These operations are planned for a calculated gain in life expectancy and it would be reasonable for there to be a degree of centralisation of referral and development of surgical expertise. We use beta-blockade for life, both before and after surgery, in all patients with Marfan's syndrome with aortic root enlargement. The data on which these recommendations are based are incomplete and we can only hope that with an increasing number of carefully documented cases we will refine them and improve upon them in the future. The concept of a "forme fruste" or a "Marfanoid aorta" in the absence of the syndrome is highly questionable so the comments made apply only to patients with Marfan's syndrome--not to other forms of annuloaortic ectasia or other less well characterised forms of aortic root disease.
对于那些我们认为处于高风险的患者，我们提供选择性主动脉置换术。主动脉根部尺寸及其增长速度是我们所拥有的最佳预测指标。我们认为5.5厘米可能是上限，并且倾向于在高风险家族以及计划怀孕的女性中更早阶段就提倡手术。这些手术旨在预期延长寿命，转诊集中化和发展手术专业技能是合理的。对于所有患有马凡综合征且主动脉根部扩大的患者，我们在术前和术后都终身使用β受体阻滞剂。这些建议所依据的数据并不完整，我们只能希望随着越来越多记录详尽的病例出现，未来我们能够完善并改进这些建议。在没有该综合征的情况下，“顿挫型”或“类马凡主动脉”的概念极具疑问，因此所做评论仅适用于马凡综合征患者，不适用于其他形式的主动脉环扩张或其他特征不明确的主动脉根部疾病形式。
