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June 24, 2023European Journal of Cardio-Thoracic SurgeryOpen Access

Bentall ARR shows similar 10-year survival to VSRR but is linked to ~89% less recurrent AI.

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Why the study?

Short- and long-term outcomes of patients with moderate-to-severe aortic insufficiency undergoing either Bentall aortic root replacement or valve-sparing root replacement required examination.

Does valve-sparing root replacement compared to Bentall aortic root replacement improve outcomes in adult patients with root pathology and moderate-to-severe aortic insufficiency?

Population

1527 adult patients with moderate-to-severe AI (195 propensity-matched pairs)

Comparison

Bentall ARR vs VSRR

Design

Two-centre retrospective propensity-matched study

Key result

Bentall aortic root replacement and valve-sparing root replacement showed similar 10-year survival (84% vs 82%, P=0.69), though Bentall ARR had less recurrence of moderate-to-severe AI (1.6% vs 14%, P=0.002).

Authors

ENElizabeth L. NortonPPParth PatelDLDov Levine

Discussion

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Member takes

Overview

Similar survival supports individualized root replacement choice; leaves open durability questions for prospective confirmation.

Study Design

Type

Cohort (n=1,527)

Multicenter

Yes

Structured PICO

Does valve-sparing root replacement compared to Bentall aortic root replacement improve outcomes in adult patients with root pathology and moderate-to-severe aortic insufficiency?

P
Population
1,527 adult patients (195 propensity-matched pairs) with moderate-to-severe aortic insufficiency undergoing Bentall or valve-sparing aortic root replacement, evaluated for up to 10-year survival.
E
Exposure
Valve-sparing root replacement (VSRR)
C
Comparator
Bentall aortic root replacement (ARR)
O
Outcome
Perioperative outcomes, reoperation rates, recurrence of AI, and long-term survivalhard clinical

Main Result

Absolute Event Rate: 84% vs 82%

p-value: p=0.69

Both Bentall and valve-sparing aortic root replacement offer acceptable and similar long-term survival for root pathology with moderate-to-severe AI, though Bentall is associated with lower rates of recurrent AI.

Cite This Study

Norton et al. (2023) conducted a cohort in Moderate-to-severe aortic insufficiency with root pathology (n=1,527). Bentall aortic root replacement (ARR) vs. Valve-sparing root replacement (VSRR) was evaluated on 10-year survival (p=0.69). Bentall aortic root replacement and valve-sparing root replacement showed similar 10-year survival (84% vs 82%, P=0.69), though Bentall ARR had less recurrence of moderate-to-severe AI (1.6% vs 14%, P=0.002).

synapsesocial.com/papers/6aa21a751f0a798fe527c4e5https://doi.org/10.1093/ejcts/ezad231
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Early and long-term outcomes of conventional and valve-sparing aortic root replacement2022 · 18 citations
  2. 2Repair of aortic root in patients with aneurysm or dissection: comparing the outcomes of valvesparing root replacement with those from the Bentall procedure2013 · 18 citations
  3. 3Valve‐sparing versus valve‐replacing aortic root replacement in patients with aortic root aneurysm2022 · 10 citations
  4. 4Long-term outcomes comparison of Bentall-De Bono-versus valve-sparing aortic root replacement: An updated systematic review and reconstructed time-to-event meta-analysis2024 · 9 citations
  5. 5Comparing outcomes between valve-sparing root replacement and the Bentall procedure in proximal aortic aneurysms: systematic review and meta-analysis2019 · 32 citations