Biological solutions to aortic root replacement: valve-sparing versus bioprosthetic conduit‡
Key result
Valve-sparing operations are linked to ~42% fewer mid-term aortic valve reoperations versus biologic root replacement.
- P=0.026
- n=749
Why the study?
Does a valve-sparing operation compared to root replacement with a biologic composite conduit improve outcomes in patients with aortic root aneurysm?
Population
749 consecutive patients with aortic root aneurysm, mean age 57.4 years, 84.6% male.
Comparison
Valve-sparing operation vs Root replacement with a biologic composite conduit
Design
Cohort
Follow-up
mean 27.5 ± 28.4 months
Authors
Discussion
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Member takes
Implication
Biologic conduits warrant caution for reoperation risk in aortic root aneurysm; leaves open need for randomized durability data versus valve-sparing repair.
Study Design
Type
Cohort (n=749)
Multicenter
Yes
Structured PICO
Does a valve-sparing operation compared to root replacement with a biologic composite conduit improve outcomes in patients with aortic root aneurysm?
P
Population
749 patients (mean age 57.4 years, 15.4% female) with aortic root aneurysm undergoing valve-sparing operation or root replacement with a biologic composite conduit, followed for a mean of 27.5 months.
E
Exposure
Valve-sparing operation
C
Comparator
Root replacement with a biologic composite conduit
O
Outcome
In-hospital deaths and reoperation on the aortic valve at mean 27.5 months follow-uphard clinical
Main Result
Absolute Event Rate: 1.5% vs 2.6%
p-value: p=0.026
Both valve-sparing operations and root replacement with a biologic composite conduit provide excellent outcomes for aortic root aneurysm, though biologic conduits are associated with a higher mid-term risk of reoperation.
Cite This Study
Gaudino et al. (2017) conducted a cohort in Aortic root aneurysm (n=749). Valve-sparing operation vs. Root replacement with a biologic composite conduit was evaluated on Reoperation on the aortic valve (p=0.026). Valve-sparing operations for aortic root aneurysm were associated with a lower risk of mid-term aortic valve reoperation compared to biologic composite conduit root replacement (1.5% vs 2.6%; P=0.026).