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0362 : Marfan syndrome diagnosed during childhood: focus on cardiac events in the French database

Abstract : Objectives Life expectancy of patients with Marfan syndrome has increased, due to earlier diagnosis, better familial screening, regular follow-up (FU) and prophylactic aortic surgery (PASu). Incidence of events in affected patients recognized during childhood is unknown. Methods 465 patients with Marfan syndrome, diagnosed before 18y.o. were included in the French multicenter database. Cardio-vascular events (death, aortic dissection or PASu) were recorded Results A cardio-vascular event occurred in 25 patients (5.4% 95CI 3.5- 7.8%), including PASu (n=20, 4.3% 95CI 2.5-6.2%), aortic dissection (n=3, 0.6% 95CI 0.0-1.4%) and deaths (n=2, 0.4% 95CI 0.0-1.0%). 16 events (64%) occurred before 19 year-old (Median 15.0, min 2.8, interquartile 11.7-16.3; PASu n=12, deaths n=2 and dissection n= 2). An aortic surgery was performed in 23 patients (4.9%, 95CI 3.0-6.9%), including a Bentall procedure with mechanical aortic valve in 10 (43.5%), a valve sparing surgery in the remaining 13 (56.5%) and a supra-coronary graft in 4 (17.4%, dissection: n=2 and PASu: n=2). Mean age at the date of PASu was 17.1±6.5 year-old. Events occurred before or at inclusion in the database in 8 patients (32.0%) (PASu n=5, dissection n=2, death n=1). Dissection was observed before inclusion in 2 patients and during pregnancy in 1 patient. Kaplan-Meier survival estimate indicates that 95% of patients remained free from events at eighteen and 78% at thirty year-old. Conclusion Prophylactic surgery for enlarged aorta is the main cause of cardiac events in patients with Marfan syndrome diagnosed during childhood. A quarter of them have a cardiac event before thirty year-old.
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-01150493
Contributor : Laurent Jonchère <>
Submitted on : Monday, May 11, 2015 - 1:35:43 PM
Last modification on : Wednesday, August 19, 2020 - 12:08:09 PM

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Sébastien Hascoët, Yves Dulac, Thomas Edouard, Sophie Dupuis-Girod, Florence Arnoult, et al.. 0362 : Marfan syndrome diagnosed during childhood: focus on cardiac events in the French database. Archives of Cardiovascular Diseases Supplements, Apr 2015, Toulouse, France. pp.213, ⟨10.1016/S1878-6480(15)30222-6⟩. ⟨hal-01150493⟩

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