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The appropriateness of aortic valve–sparing operations in patients with Marfan syndrome has been questioned. This study examines the long-term results of these operations in patients with Marfan syndrome.

From 1988 to 2006, 103 consecutive patients with Marfan syndrome (mean age, 37 ± 12 years) and aortic root aneurysm had aortic valve–sparing operations. Emergency surgery was performed in 11 patients: 8 for acute type A aortic dissection and 3 for unexplained persistent chest pain. Fourteen patients also had mitral valve surgery. The technique of aortic valve reimplantation was used in 77 patients, and aortic root remodeling was used in 26 patients. Patients were followed prospectively and underwent annual echocardiographic studies. The mean follow-up was 7.3 ± 4.2 years and 100% complete.

There was 1 operative death and 5 late deaths. Four of the 6 deaths …