**Author details**

450 Aneurysm

MFS.

indicated.

regurgitations.

**3. Conclusion** 

anticoagulation therapy.

patients without Marfan's syndrome.

methods are the ones preferred.

**2.13. Other cardiovascular manifestations of the SM** 

unfavorable surgical results in younger than 2 years old, being an important reason for mortality in children with MFS. In teenagers and adults the surgical repair of the severe

The mitral isolated surgery is infrequent, and in the majority of the occasions we carry out combined conservative procedures on the aorta and the mitral valves to avoid the

The extensive calcification of the mitral ring is the main contraindication for the mitral repair in the MFS. It is important to insist that not repair severe mitral regurgitation, concerns adversely the aortic hemodynamic stress and the ventricular function in the

In a similar way to the case of the aortic valve, the classic method used in patients with severe mitral regurgitation is the valve replacement, usually with mechanical prosthesis. Nevertheless, and given the high morbidity that these can produce over the years because of the thromboembolic and infectious events, the conservative mitral valve techniques are the gold standard of the mitral surgery, with long-term results similar to the ones obtained in

Before this type of valves, the surgeon must use the whole available technical equipment and devices, being in an extensively use the PTFE's neocordae, and always associating annuloplasty rings, preferably rigidly or semi rigid. In occasions, it is used the double orifice technique, described by Alfieri, less demanding technically, though the anatomical repair

The immediate and long-term results are very good, with events free survival and reintervention free survival of 95 % at 10 years, specially when the early surgery is

The expansion of the trunk of the pulmonary artery is less frequent than the aortic one, and rarely it causes dissection. In the MFS it is possible to have alterations in the atrioventricular conduction and in the ventricular repolarization (long QT, ST alterations and U waves), that might be associated with ventricular arrhythmias, but it is not clear if these changes are secondary to a primary myocardiopathie or to ventricular dilatation owed to the evolved

The diagnosis of Marfan syndrome is inevitably complex, due to the high variability of presentation of affected individuals, the dependence of the age in many clinical manifestations, the absence of gold standards diagnostic tests, and the wide differential diagnosis. The new Marfan syndrome diagnostic criteria are intended to facilitate a

mitral severe regurgitation is associated with a high events free survival.

Miguel Angel Ramirez-Marrero\*, Beatriz Perez-Villardon, Ricardo Vivancos-Delgado and Manuel de Mora-Martin *Cardiology Department, Regional University Hospital Carlos Haya, Malaga, Spain* 
