OC12 CLINICAL OUTCOMES OF PERSONALISED EXTERNAL AORTIC ROOT SUPPORT SURGERY: THE OXFORD EXPERIENCE

Abstract

Background and aim: Personalized external aortic root support (PEARS) is a novel technique for prophylactic treatment of moderate aortic dilatation. A replica of the patient's root and ascending aorta is constructed by combining MRI imaging and 3D printing. The ExoVasc stent is surgically implanted around the aorta. We present the Oxford clinical experience with PEARS. Method: 7 patients (age 33.68 ± 16.04 years), 5 (71.4%) male, with Marfan Syndrome and root dilatation underwent ExoVasc stent implant. 5 procedures were performed in Oxford (JRH) and 2 in other UK centres as part of our proctoring programme (2012–2017). 3 patients underwent isolated PEARS surgery and 4 had concomitant mitral valve repair. Results: All patients underwent successful ExoVasc implant. Cardio-pulmonary bypass (CPB) was not required for isolated procedures. In the 4 combined cases, most of the stent implant was performed before and after CPB (mean CPB 145.75 ± 9.90 minutes). One patient required a second CPB run to revise the repair. No patient suffered major complications or required transfusions. Mean post-operative ICU and hospital LOS were 1.4 ± 1.4 and 5.7 ± 1.4 days. Pre-discharge and follow-up echo confirmed successful mitral valve repair. MRI follow-up at 3.94 ± 1.45 years of the first 5 patients showed no progression of the root and ascending aorta diameters. An incidental isolated type B dissection was found 3 years after surgery. Conclusion: PEARS represents an attractive alternative to extensive prophylactic surgery (i.e. valve sparing aortic root replacement) particularly for patients with MFS who required concomitant mitral surgery.