The Florida Sleeve: Procedure introduced by UF Health is shown to be durable and effective in Marfan syndrome patients with aortic root aneurysm
A recent retrospective study published by a team at University of Florida Health has shown that the Florida Sleeve procedure — originally developed at UF approximately 15 years ago — is associated with encouraging results in Marfan syndrome patients with aortic root aneurysm. This valve-sparing technique involves protecting the aortic root with a Dacron sleeve while leaving native tissue in place.
Tomas Martin, M.D., a professor of surgery in the division of thoracic and cardiovascular surgery at the University of Florida College of Medicine and director of the UF Health Aortic Disease Center, is one of the pioneers of the Florida Sleeve procedure. He attributes the widespread national and international acceptance of this technique to the relative ease with which it can be conceptualized and performed compared with other valve-sparing techniques. “This study,” he notes, “shows that the Florida Sleeve is a viable option for patients with Marfan syndrome.” With a significant reduction in aortic insufficiency grade postoperatively, no in-hospital or 30-day death or stroke, 94% survival at 1 to 8 years, and 100% freedom from reoperation at 8 years, “our study shows that this technique is excellent for use in this group of patients, with good short- and mid-term results.”
Aortic root aneurysm is common in patients with Marfan syndrome and UF Health has been using the Florida Sleeve in these patients since the procedure was first developed . However, some surgeons have concerns about the long-term durability and dimensional stability of this repair, and about the potential need for reoperation in these patients. According to Martin, this analysis — which represents follow-up of the largest cohort of Marfan syndrome patients treated with the Florida Sleeve — shows that “none of the problems that people anticipated have happened.”
It is Martin’s hope that these encouraging results will lead to an increase in use of the Florida Sleeve in patients with Marfan syndrome and that, as a result, “more of these patients will have their native aortic valve saved.”
Aalaei-Andabili SH, Martin T, Hess P, Klodell C, Karimi A, Arnaoutakis G, Lee T, Beaver T. Florida Sleeve Procedure Is Durable and Improves Aortic Valve Function in Marfan Syndrome Patients. Ann Thorac Surg. 2017 Sep;104(3):834-839. doi: 10.1016/j.athoracsur.2017.01.044. Epub 2017 Apr 12.