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San Diego: Cleveland Clinic researchers found that patients with Loeys-Dietz Syndrome (LDS) had better outcomes when they were treated early with preventative aortic surgery.
The research was presented at the American Association for Thoracic Surgery’s 98th Annual Scientific Session and simultaneously published in the Journal of Thoracic and Cardiovascular Surgery.
LDS is a recently recognized disease, identified in 2005 as a connective tissue disorder caused by a genetic mutation. It’s often characterized by enlargement of the aorta and the rapid development of aortic aneurysms, if not treated prior to aortic dissection, which is a life-threatening tear of the aorta.
“Loeys Dietz is an uncommon inherited disorder that we have begun to understand better because of tissue research and genetic analysis,” said Lars Svensson, M.D., chair of the Miller Family Heart & Vascular Institute. “Our research following these patients shows prophylactic surgery is very safe and effective in preventing death overtime.”
Over the past decade, Cleveland Clinic has developed a registry for LDS patients at the Aorta Center in the Heart & Vascular Institute at Cleveland Clinic. Fifty-three LDS patients were retrospectively identified and reviewed who had been medically treated or underwent surgical management at Cleveland Clinic prior to April 2017. Primary outcomes evaluated were postoperative in-hospital morbidity and mortality; secondary end points were aorta-related reoperations and short- and long-term mortality. Survival by Kaplan-Meier analysis was 89 percent at 10 years.
Of the 53 patients with genetically confirmed LDS included in the analysis, 33 (62 percent) underwent aortic surgery and 20 had not required aortic surgery as of last follow-up through April 2017. The latter 20 patients were treated medically (aggressive blood pressure control to minimize aortic wall stress) and received ongoing clinical and radiologic surveillance; these patients constituted the “non-aortic surgery group.”
Among the 33 patients who had aortic surgery, mean age at the index operation was 39 years (four patients were younger than 18) and maximum aortic diameter was 4.3 cm. Among the 20 patients in the non-aortic surgery group, mean age was 23 years and maximum aortic diameter was 3.4 cm.
LDS is considered an autosomal-dominant connective tissue disorder caused by a mutation in two transforming growth factor β receptor genes. Lifelong management for LDS patients is crucial to a long-term successful prognosis and to avoid aortic dissections.
Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. Cleveland Clinic is consistently recognized in the U.S. and throughout the world for its expertise and care. Among Cleveland Clinic’s 82,600 employees worldwide are more than 5,786 salaried physicians and researchers, and 20,700 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties. Cleveland Clinic is a 6,728-bed health system that includes a 173-acre main campus near downtown Cleveland, 23 hospitals, 280 outpatient facilities, including locations in northeast Ohio; Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2024, there were 15.7 million outpatient encounters, 333,000 hospital admissions and observations, and 320,000 surgeries and procedures throughout Cleveland Clinic’s health system. Patients came for treatment from every state and 112 countries. Visit us at clevelandclinic.org. Follow us at x.com/CleClinicNews. News and resources are available at newsroom.clevelandclinic.org.
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