Aortic root dilation is nearly universal among patients with Marfan syndrome (MFS) and many patients require aortic root replacement to prevent devastating aortic catastrophe. This has traditionally entailed placement of a composite-valved graft, often with a mechanical aortic valve, necessitating lifelong anticoagulation. In the 1990s, a significant development within the field of cardiac surgery occurred, and valve sparing root replacement (VSRR) techniques were developed and refined. These allow prophylactic replacement of aortic root aneurysms while sparing a healthy, functioning aortic valve. These techniques have been shown to be safe and durable in patients with MFS.1 2 However, VSRR is a technically demanding procedure that is not available in all cardiac centres. This has led some to investigate alternatives to VSRR, in an effort to make these repairs both safer and more generalisable within the cardiac surgical community. Van Hoof and colleagues3 report outcomes on the first 200 consecutive patients undergoing the personalized external aortic root support (PEARS) procedure. The results of this innovative procedure are very encouraging, with a 0.5% perioperative mortality. Late reoperations were only performed in three patients, and no type A dissections occurred during the follow-up period. Further, the PEARS procedure seems to have a positive impact on aortic regurgitation and medium-term valve outcomes seem promising. These results are remarkable and the authors and surgeons dedicated to pioneering this innovative approach …

中文翻译：

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个性化的外主动脉根部支持程序：有趣的利基市场还是准备好迎接黄金时段？

主动脉根部扩张在马凡综合征 (MFS) 患者中几乎普遍存在，许多患者需要主动脉根部置换以防止破坏性主动脉灾难。这传统上需要放置复合瓣膜移植物，通常带有机械主动脉瓣，需要终生抗凝。1990 年代，心脏外科领域取得了重大进展，瓣膜保留根部置换 (VSRR) 技术得到了发展和完善。这些允许预防性更换主动脉根部动脉瘤，同时保留健康、功能正常的主动脉瓣。这些技术已被证明对 MFS 患者是安全和持久的。1 2 然而，VSRR 是一项技术要求很高的程序，并非在所有心脏中心都可用。这导致一些人研究 VSRR 的替代方案，努力使这些修复在心脏外科界更安全、更普遍。Van Hoof 及其同事 3 报告了前 200 名连续接受个性化外主动脉根部支持 (PEARS) 手术的患者的结果。这种创新手术的结果非常令人鼓舞，围手术期死亡率为 0.5%。仅3例患者进行了晚期再手术，随访期间未发生A型夹层。此外，PEARS 手术似乎对主动脉瓣关闭不全有积极影响，中期瓣膜结果似乎很有希望。这些结果是显着的，作者和外科医生致力于开创这种创新方法…… Van Hoof 及其同事 3 报告了前 200 名连续接受个性化外主动脉根部支持 (PEARS) 手术的患者的结果。这种创新手术的结果非常令人鼓舞，围手术期死亡率为 0.5%。仅3例患者进行了晚期再手术，随访期间未发生A型夹层。此外，PEARS 手术似乎对主动脉瓣关闭不全有积极影响，中期瓣膜结果似乎很有希望。这些结果是显着的，作者和外科医生致力于开创这种创新方法…… Van Hoof 及其同事 3 报告了前 200 名连续接受个性化外主动脉根部支持 (PEARS) 手术的患者的结果。这种创新手术的结果非常令人鼓舞，围手术期死亡率为 0.5%。仅3例患者进行了晚期再手术，随访期间未发生A型夹层。此外，PEARS 手术似乎对主动脉瓣关闭不全有积极影响，中期瓣膜结果似乎很有希望。这些结果是显着的，作者和外科医生致力于开创这种创新方法…… 仅3例患者进行了晚期再手术，随访期间未发生A型夹层。此外，PEARS 手术似乎对主动脉瓣关闭不全有积极影响，中期瓣膜结果似乎很有希望。这些结果是显着的，作者和外科医生致力于开创这种创新方法…… 仅3例患者进行了晚期再手术，随访期间未发生A型夹层。此外，PEARS 手术似乎对主动脉瓣关闭不全有积极影响，中期瓣膜结果似乎很有希望。这些结果是显着的，作者和外科医生致力于开创这种创新方法……