The National Institute for Health and Care Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on External aortic root support in Marfan syndrome in May 2011. NICE is currently updating this guidance. The new guidance will be published shortly. Until then the NHS should continue to follow the recommendations outlined in the current version of the guidance. The Interventional Procedures Advisory Committee (IPAC) will consider this procedure review and NICE will issue an interventional procedures consultation document about its safety and efficacy for 4 weeks’ public consultation. IPAC will then review the consultation document in the light of comments received and produce a final interventional procedures document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.
 
Status In progress
Process IP
ID number 885
Description The aim of external aortic root support in Marfan syndrome is to reinforce the aorta and prevent its enlargement and subsequent dissection or rupture. The native aortic valve is left intact, cardiopulmonary bypass is usually not needed and operative time is reduced. There is no need for lifelong anticoagulation after the procedure. In the first step of the procedure, imaging studies are done of the patient’s ascending aorta and aortic root. Computer-aided design is then used to create a model of the aorta, which is used to make a bespoke external polymer mesh support. Under general anaesthesia, a median sternotomy is done and the aorta is dissected away from adjacent structures. The mesh support is passed behind the aorta and sutured up the front. It is secured around the brachiocephalic artery at the distal end, thereby supporting the whole of the ascending aorta and aortic root. The operation is usually done without cardiopulmonary bypass.

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For further information on how we develop guidance, please see our page about NICE interventional procedures guidance