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Impact of Aortic Valve Function and the Need for Aortic Valve Repair on Long-Term Outcomes of Valve-Sparing Aortic Root Replacement: 13-Year Experience of David Operation. | LitMetric

AI Article Synopsis

  • - This study evaluates the outcomes of valve-sparing aortic root replacement (VSARR) in patients with aortic root disease, particularly focusing on those with moderate or severe aortic regurgitation (AR) and the need for aortic valve repair (AVR).
  • - From 2005 to 2018, 104 patients underwent VSARR, with a low in-hospital mortality rate of 2.9% and high long-term success, as indicated by 95.4% freedom from reoperation after 8 years.
  • - The results suggest that VSARR is a safe procedure that maintains aortic valve function over time, regardless of the severity of preoperative AR or the requirement for AVR during surgery.

Article Abstract

Background: The best approach for aortic root disease remains controversial. Composite valve-graft conduit (CVG) replacement offers good results at short-term and long-term follow-up; on the other hand, valve-sparing aortic root replacement (VSARR) has proven to be an excellent treatment alternative. This study aimed to analyse the outcomes after VSARR and compare whether preoperative moderate or severe aortic regurgitation (AR) and or the need for aortic valve repair (AVR) during this procedure influenced survival and freedom from reoperation rates.

Methods: From September 2005 to June 2018, 104 patients underwent VSARR using the reimplantation technique: 64% presented with preoperative moderate or severe AR, concomitant AVR was performed in 43.3%, Marfan syndrome was present in 16.3%, and 12.5% had a bicuspid aortic valve. Complete follow-up was obtained in 91% of the sample, echocardiographic results were available for 86% and the mean follow-up time was 1,893 days.

Results: In-hospital mortality was 2.9% and one death occurred 42 days after hospital discharge. In the latest echocardiographic assessment, 88.3% presented with mild AR or better. Freedom from reoperation at 8 years was 95.4%. There was no case of endocarditis and one patient had a stroke 2 years after the operation. There were no between-group differences in morbidity, mortality and complications during the follow-up.

Conclusion: VSARR can be performed with low mortality rates and reasonable durability of the aortic valve. Neither moderate or severe AR nor the need for aortic valve repair during the procedure altered survival and freedom from reoperation.

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Source
http://dx.doi.org/10.1016/j.hlc.2020.10.020DOI Listing

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