Evidence map›Paper›PMID 42229999›Full record

ArticleOpen heart2026

Cardiac surgical outcomes and predictors of redo sternotomy in patients with Marfan syndrome: a retrospective multicentre cohort study.

Hussein Abdul Nabi, Luke Arnulfo Dreher, Christopher Kanaan, Hana Mousa, Omneya Kandil, Ashley Crossley, Yuxiang Wang, Hicham Z El Masry, Chadi Ayoub, Kristen Sell-Dottin and 1 more

Abstract readMulticenter Study
In one paragraph

Article in Open heart, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Lymphatic therapies open the valve in Marfan syndrome.The Journal of clinical investigation · 2026
    Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Hussein Abdul Nabi *Department of Cardiovascular Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA.ORCID http://orcid.org/0009-0006-0940-0168
Luke Arnulfo Dreher *Department of Cardiovascular Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA.ORCID http://orcid.org/0000-0002-5144-9292
Christopher KanaanDepartment of Cardiovascular Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA.
Hana MousaDepartment of Cardiovascular Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA.
Omneya KandilDepartment of Cardiovascular Surgery, Mayo Clinic Arizona, Scottsdale, Arizona, USA.
Ashley CrossleyDepartment of Cardiovascular Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA.
Yuxiang WangDepartment of Cardiovascular Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA.
Hicham Z El MasryDepartment of Cardiovascular Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA.
Chadi AyoubDepartment of Cardiovascular Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA.
Kristen Sell-DottinDepartment of Cardiovascular Surgery, Mayo Clinic Arizona, Scottsdale, Arizona, USA.
Fadi E ShamounDepartment of Cardiovascular Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA shamoun.fadi@mayo.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMarfan syndrome (MFS) is associated with progressive aortic and valvular disease requiring cardiac surgery, but contemporary data on repeat cardiac operations in adults remain limited.

methodsWe performed a retrospective multicentre cohort study of 783 adults with MFS evaluated across three Mayo Clinic sites. Cardiac operations, postoperative complications, echocardiographic findings and redo sternotomy events were identified by chart review. Multivariate logistic regression was used to evaluate factors associated with redo sternotomy.

resultsOverall, 454 patients (58.0%) underwent at least one cardiac operation, and 185 patients (23.6% of the total cohort; 41.0% of operated patients) required redo sternotomy. The most common procedures were aortic root intervention (53.4%), aortic valve intervention (39.6%), mitral valve intervention (16.1%) and tricuspid valve intervention (2.6%). Valvular abnormalities were frequent, including mitral regurgitation (51.5%), mitral valve prolapse (41.1%), tricuspid regurgitation (44.6%) and aortic regurgitation (28.5%). Major postoperative complications occurred in 15.3% of patients. On multivariate analysis, hypertension (OR 2.39, 95% CI 1.54 to 3.72), emergent initial operation (OR 3.38, 95% CI 1.97 to 5.80) and postoperative complications (OR 2.59, 95% CI 1.58 to 4.27) were independently associated with redo sternotomy, whereas repair extending beyond the aortic root was associated with lower odds (OR 0.39, 95% CI 0.29 to 0.53).

conclusionIn this large multicentre cohort of adults with MFS, cardiac surgery was common, and redo sternotomy occurred frequently among operated patients. These findings provide a contemporary description of the long-term need for cardiac surgery in adults with MFS managed at tertiary referral centres.

Indexed as

Cardiac Surgical ProceduresHeart Valve DiseasesMarfan SyndromePostoperative ComplicationsSternotomyAdultFemaleHumansMaleMiddle AgedMinnesotaReoperationRetrospective StudiesRisk FactorsTime FactorsTreatment OutcomeAortic AneurysmCardiac Surgical ProceduresHeart Valve DiseasesMarfan SyndromeRisk Factors

Identifiers

PMID42229999
PMCPMC13239629

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.