Outcomes of Type B Dissection in Marfan Syndrome: The Cornell Aortic Aneurysm Registry

BACKGROUND: Rates of type B dissection are nearly double those of type A in Marfan syndrome. However, data surrounding clinical and surgical outcomes of type B dissection and associated life expectancy are limited. METHODS: We investigated outcomes and survival of type B dissection in a large, single-center Marfan syndrome registry. RESULTS: =0.004) with comparable postdissection life expectancy. Postdissection survival did not differ on the basis of timing of surgery or medical management. Eleven patients (5.9% of those with prior root replacement) suffered a distal anastomosis dissection at a median of 18.0 (interquartile range, 12.1-23.1) years postoperatively, of whom 9 required surgery after a median of 0.59 months (interquartile range, 0.13-12.3). CONCLUSIONS: Type B dissection in Marfan syndrome is associated with a shortened life expectancy, but only in men, and usually requires surgical intervention. Distal anastomosis dissection is an underappreciated, important complication after proximal aortic surgery.