Bentall versus valve-sparing aortic root replacement for root pathology with moderate-to-severe aortic insufficiency : a propensity-matched analysis
© The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved..
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.
| Errataetall: |
CommentIn: Eur J Cardiothorac Surg. 2023 Aug 1;64(2):. - PMID 37490465 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:64 |
|---|---|
| Enthalten in: |
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery - 64(2023), 2 vom: 01. Aug. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Norton, Elizabeth L [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Aortic insufficiency |
|---|
| Anmerkungen: |
Date Completed 10.08.2023 Date Revised 16.10.2023 published: Print CommentIn: Eur J Cardiothorac Surg. 2023 Aug 1;64(2):. - PMID 37490465 Citation Status MEDLINE |
|---|
| doi: |
10.1093/ejcts/ezad231 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM358558867 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM358558867 | ||
| 003 | DE-627 | ||
| 005 | 20231226075015.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/ejcts/ezad231 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1195.xml |
| 035 | |a (DE-627)NLM358558867 | ||
| 035 | |a (NLM)37354518 | ||
| 035 | |a (PII)ezad231 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Norton, Elizabeth L |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Bentall versus valve-sparing aortic root replacement for root pathology with moderate-to-severe aortic insufficiency |b a propensity-matched analysis |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 10.08.2023 | ||
| 500 | |a Date Revised 16.10.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Eur J Cardiothorac Surg. 2023 Aug 1;64(2):. - PMID 37490465 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a CONCLUSIONS: Both ARR and VSRR can be performed with acceptable short- and long-term outcomes in patients with moderate-to-severe AI | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Aortic insufficiency | |
| 650 | 4 | |a Aortic root replacement | |
| 650 | 4 | |a Valve-sparing | |
| 700 | 1 | |a Patel, Parth M |e verfasserin |4 aut | |
| 700 | 1 | |a Levine, Dov |e verfasserin |4 aut | |
| 700 | 1 | |a Wei, Jane W |e verfasserin |4 aut | |
| 700 | 1 | |a Binongo, Jose N |e verfasserin |4 aut | |
| 700 | 1 | |a Leshnower, Bradley G |e verfasserin |4 aut | |
| 700 | 1 | |a Takayama, Hiroo |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Edward P |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery |d 1996 |g 64(2023), 2 vom: 01. Aug. |w (DE-627)NLM012606200 |x 1873-734X |7 nnns |
| 773 | 1 | 8 | |g volume:64 |g year:2023 |g number:2 |g day:01 |g month:08 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/ejcts/ezad231 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 64 |j 2023 |e 2 |b 01 |c 08 | ||