Key result
Valve-sparing aortic root reimplantation reduces severe AI to ~0% post-operation with low in-hospital mortality.
Why the study?
The authors sought to report the short- and mid-term outcomes and single-center experience with valve-sparing aortic root reimplantation.
Does valve-sparing aortic root reimplantation improve aortic insufficiency and provide safe outcomes in patients with aortic root aneurysms?
Cohort (n=40)
No
Does valve-sparing aortic root reimplantation improve aortic insufficiency and provide safe outcomes in patients with aortic root aneurysms?
Absolute Event Rate: 0% vs 62.5%
p-value: p=<0.001
David's procedure for aortic root aneurysms demonstrates excellent mid-term safety and significant improvement in aortic insufficiency.
Supports consideration of valve-sparing reimplantation for aortic root aneurysms; leaves open randomized comparison on durability versus replacement.
BACKGROUND: In the current study, we aimed to report the short- and mid-term outcomes of patients undergoing valve-sparing aortic root reimplantation (VSARR) and our center's experience with the procedure. METHODS: Forty patients with aortic root aneurysms underwent VSARR at our center from 2010 until 2022. We retrospectively reviewed the medical records of these patients and extracted the relevant data. After carefully examining the aortic valve, the surgeon decided to perform Bentall or David's procedure during the operation. RESULTS: The study population comprised 31 (77.5%) men and nine (22.5%) women, with a mean age of 55.35 ± 15.40. One patient developed hemodynamic instability post-surgery in the hospital and died from multi-organ failure. Another patient had severe AI in the intraoperative echocardiography, and aortic valve replacement with a prosthetic graft was performed during the same operation. In pre-operation echocardiography, 25 (62.5%) patients had severe, nine (22.5%) had moderate, and six (15%) had mild AI. In the in-hospital post-operation follow-up echo, AI was improved, and no patients had severe AI (P < 0.001). Only eight patients had moderate AI in post-one-year follow-up echo exams, while the rest had mild AI. CONCLUSION: David's procedure showed excellent mid-term results in our center, with only one in-hospital mortality.
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Omran et al. (2024) conducted a cohort in Aortic root aneurysm (n=40). Valve-sparing aortic root reimplantation (David's procedure) was evaluated on Severe aortic insufficiency (p=<0.001). Valve-sparing aortic root reimplantation (David's procedure) resulted in a low in-hospital mortality of 2.5% and significantly reduced the prevalence of severe aortic insufficiency from 62.5% at baseline to 0% post-operation (P<0.001).
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