Surgical Management of Aortic Root Dilatation with Advanced Aortic Regurgitation: Bentall Operation versus Valve-sparing Procedure
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Key result
Aortic valve-sparing matches Bentall survival but is linked to more recurrent advanced aortic regurgitation.
Why the study?
Does the aortic valve-sparing procedure improve overall survival and reduce valve-related complications compared to the Bentall operation in patients with aortic root dilatation and advanced aortic regurgitation?
Population
120 patients with aortic root dilatation and moderate to severe aortic regurgitation
Comparison
Aortic valve-sparing procedure vs Bentall operation
Design
Cohort
Follow-up
mean 4.9±3.1 years
Authors
Discussion
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Implication
Valve-sparing may increase recurrent AR risk without survival benefit; leaves open optimal choice pending randomized trials.
Study Design
Type
Cohort (n=120)
Structured PICO
Does the aortic valve-sparing procedure improve overall survival and reduce valve-related complications compared to the Bentall operation in patients with aortic root dilatation and advanced aortic regurgitation?
P
Population
120 patients who underwent surgery for aortic root dilatation with moderate to severe aortic regurgitation, followed for a mean of 4.9 years.
E
Exposure
Aortic valve-sparing procedure
C
Comparator
Bentall operation
O
Outcome
Overall survival, valve-related complications, and aortic valve functionhard clinical
Main Result
Hazard Ratio: 0.61
p-value: p=0.45
While valve-sparing procedures and the Bentall operation offer comparable long-term survival for aortic root dilatation with advanced AR, valve-sparing is associated with a higher risk of recurrent advanced aortic regurgitation.
Cite This Study
Lim et al. (2012) conducted a cohort in aortic root dilatation with moderate to severe aortic regurgitation (n=120). Aortic valve-sparing procedure vs. Bentall operation was evaluated on death (HR 0.61, p=0.45). The aortic valve-sparing procedure had similar risks of death (HR 0.61; p=0.45) compared to the Bentall operation, but was associated with more frequent recurrent advanced aortic regurgitation.
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