Une étude prospective, randomisée avec un effectif plus important serait nécessaire pour compléter ces résultats. Cependant, on peut déjà être rassuré dans notre cohorte avec la survenue d’un taux faible de complications, similaire dans les deux groupes, que la crosse soit opérée ou non. Il n’y a eu aucune survenue d’accident vasculaire cérébral, ce qui est la cause de complication la plus fréquente retrouvée dans la littérature.
107
Conclusion
Le syndrome de Marfan est une pathologie qui touche toute l’aorte avec des dilatations et/ou dissections observées au niveau de la crosse ou de l’aorte descendante alors même que l’aorte initiale a été opérée de façon préventive. Au CHU de Rouen, un certain nombre de patients est opéré de la crosse aortique en préventif en complément de l’aorte
ascendante initiale. Le but de notre travail était d’étudier les premiers résultats en termes d’efficacité et de sécurité de cette chirurgie complémentaire de la crosse aortique.
Il n’a pas été retrouvé de différence significative en termes de survenue de décès d’origine cardiovasculaire et de reprise chirurgicale sur la crosse aortique avec 3 événements dans le groupe avec préservation de la crosse contre 0 dans le groupe remplacement de la crosse (p=0.26).
Cependant, la chirurgie complémentaire de la crosse apparaît comme une chirurgie sûre sans augmentation du nombre de complications.
108
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