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OBJECTIVE: The Florida Sleeve (FS) procedure was developed as a simplified approach for repair of functional type I aortic insufficiency (AI) secondary to aortic root aneurysm. We evaluated post-operative aortic valve function and long term survival of Marfan’s disease patients who underwent the Florida Sleeve procedure at our center.
METHODS: Marfan’s patients undergoing Florida Sleeve between May 2002 and March 2014 were examined for in hospital and long term outcomes. Echo assessment included Left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), ejection fraction (EF), and degree of AI (none=0, minimal=1, mild=2, moderate=3, severe=4). SSDI was used for long term follow-up.
RESULTS: Thirty four Marfan’s patients, 21 (61.8%) male and 13 (38.2%) female mean age 35.29±13.78 years had Florida Sleeve repair at our center. There was no in-hospital or 30-day death or stroke (table-1). Two patients required reoperation due to bleeding. One and two year survival rates were 98%, and 88% at 5 years (figure-1). Fifteen patients had post-operative follow up echo at one week. AI grade significantly decreased after the procedure, (preoperative mean=2.13±1.06 versus one week post-operative mean=0.84±0.89, p-value=0.020); and mean LVEDD decreased from 55.77±7.51 to 50.07±8.36; and mean LVESD decreased from 38.66±8.27 to 35.64±10.57 (p-value=0.16 and 0.77, respectively). There was no significant change in EF (p-value=0.19). Seven patients with more than 1 year postoperative echo follow-up showed persistent improvement of AI grade and stable ventricular dimensions.
CONCLUSIONS: The Florida sleeve procedure can be performed safely in Marfan’s patients with immediate improvement in aortic valve function. Long-term survival rate is acceptable though further follow up is required.