Bentall versus valve-sparing aortic root replacement for root pathology with moderate-to-severe aortic insufficiency: a propensity-matched analysis.
Eur J Cardiothorac Surg
; 64(2)2023 08 01.
Article
in En
| MEDLINE
| ID: mdl-37354518
ABSTRACT
OBJECTIVES:
To examine short- and long-term outcomes of patients with moderate-to-severe aortic insufficiency (AI) undergoing either a Bentall aortic root replacement (ARR) or valve-sparing root replacement (VSRR).METHODS:
A two-centre retrospective database of patients undergoing ARR from 2004 to 2021 was reviewed. Patients <18 years old were excluded. A total of 1527 adult patients underwent Bentall ARR (n = 1150, 75%) or VSRR (n = 377, 25%). Propensity score matching based on preoperative comorbidities was used and 195 matched pairs were identified. Perioperative outcomes, reoperation rates, recurrence of AI and long-term survival were evaluated.RESULTS:
ARR patients had more concomitant ascending aortic replacement (35% vs 20%, P = 0.002) and shorter cardiopulmonary bypass (189 vs 233 min, P < 0.0001) and aortic cross-clamp (170 vs 204 min, P < 0.0001) times than the VSRR group. Postoperatively, outcomes were similar between groups, including stroke (3% vs 2%) and in-hospital mortality (1.5% vs 2.1%), all P > 0.05. Indications for and rates of reoperation (4% vs 5%, P = 0.62) of the aortic valve and proximal aorta were similar between ARR and VSRR groups with reoperations occurring a mean of 3.2 years after initial root replacement. The ARR group had less moderate-to-severe AI than the VSRR group (1.6% vs 14%, P = 0.002) a mean of 3 years after surgery. Ten-year survival was similar between ARR (84%) and VSRR (82%) (P = 0.69) groups.CONCLUSIONS:
Both ARR and VSRR can be performed with acceptable short- and long-term outcomes in patients with moderate-to-severe AI.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Aortic Valve Insufficiency
/
Heart Valve Prosthesis Implantation
/
Blood Vessel Prosthesis Implantation
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
Limits:
Adolescent
/
Adult
/
Humans
Language:
En
Journal:
Eur J Cardiothorac Surg
Journal subject:
CARDIOLOGIA
Year:
2023
Type:
Article
Affiliation country:
United States