November 16, 2024International Journal of CardiologyOpen Access

Long-term outcomes comparison of Bentall-De Bono-versus valve-sparing aortic root replacement: An updated systematic review and reconstructed time-to-event meta-analysis

Q: What are the key findings of this study?

Valve-sparing aortic root replacement was associated with significantly greater long-term survival compared to the Bentall-De Bono procedure (HR 0.50; 95% CI 0.45-0.57; p<0.0001).

Q: What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Aortic root dilatation and a structurally normal aortic valve (n=14651). Intervention: Valve-sparing aortic root replacement (VSARR) vs. Composite aortic valve-graft (Bentall-De Bono). Primary outcome: Long-term survival (HR 0.50, 95% CI 0.45-0.57, p=<0.0001).

Q: What does this research mean for the field?

Valve-sparing aortic root replacement is associated with significantly greater long-term survival compared to the Bentall-De Bono procedure in patients with aortic root dilatation. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Valve-sparing aortic root replacement linked to ~50% lower mortality versus the Bentall-De Bono procedure.

HR 0.50
95% CI 0.45-0.57
P<0.0001
n=14,651

Why the study?

Conflicting data exist regarding early and long-term benefits of Bentall-De Bono versus valve-sparing aortic root replacement in patients with aortic root dilatation and a structurally normal aortic valve.

Does valve-sparing aortic root replacement improve long-term survival compared to Bentall-De Bono in patients with aortic root dilatation and a structurally normal aortic valve?

Population

14,651 patients with aortic root dilatation and a structurally normal aortic valve across 39 observational studies

Comparison

Bentall-De Bono (n = 9557) vs valve-sparing aortic root replacement (n = 5094)

Design

Systematic review and reconstructed time-to-event meta-analysis

Follow-up

Mean weighted follow-up was 5.05 ± 3.7 years

Authors

FFFrancesco Formica AGAlan Gallingani SDStefano D’Alessandro

Discussion

Member takes

Overview

Supports VSARR consideration for survival in suitable patients; leaves open need for RCTs to balance reoperation risk.

Study Design

Type

Meta-Analysis (n=14,651)

Structured PICO

Does valve-sparing aortic root replacement improve long-term survival compared to Bentall-De Bono in patients with aortic root dilatation and a structurally normal aortic valve?

Population

14,651 patients with aortic root dilatation and a structurally normal aortic valve undergoing Bentall-De Bono or VSARR procedures, followed for a mean of 5.05 years.

Intervention

Valve-sparing aortic root replacement (VSARR)

Comparator

Composite aortic valve-graft (Bentall-De Bono)

Outcome

Long-term survival and reoperation risk at up to 15-year follow-uphard clinical

Main Result

Hazard Ratio: 0.5 (95% CI 0.45–0.57)

p-value: p=<0.0001

Valve-sparing aortic root replacement improves long-term survival compared to the Bentall-De Bono procedure in patients with aortic root dilatation, despite an increased risk of reoperation within the first 5 years.

Cite This Study

Formica et al. (2024) conducted a meta-analysis in Aortic root dilatation and a structurally normal aortic valve (n=14,651). Valve-sparing aortic root replacement (VSARR) vs. Composite aortic valve-graft (Bentall-De Bono) was evaluated on Long-term survival (HR 0.50, 95% CI 0.45-0.57, p=<0.0001). Valve-sparing aortic root replacement was associated with significantly greater long-term survival compared to the Bentall-De Bono procedure (HR 0.50; 95% CI 0.45-0.57; p<0.0001).

synapsesocial.com/papers/6aa70e724bfde8663e6df7ad https://doi.org/10.1016/j.ijcard.2024.132728

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November 16, 2024International Journal of CardiologyOpen Access

Long-term outcomes comparison of Bentall-De Bono-versus valve-sparing aortic root replacement: An updated systematic review and reconstructed time-to-event meta-analysis

View Full Paper

Ask AI

Bookmark

Key result

Valve-sparing aortic root replacement linked to ~50% lower mortality versus the Bentall-De Bono procedure.

HR 0.50
95% CI 0.45-0.57
P<0.0001
n=14,651

Why the study?

Does valve-sparing aortic root replacement improve long-term survival compared to Bentall-De Bono in patients with aortic root dilatation and a structurally normal aortic valve?

Population

14,651 patients with aortic root dilatation and a structurally normal aortic valve across 39 observational studies

Comparison

Bentall-De Bono (n = 9557) vs valve-sparing aortic root replacement (n = 5094)

Design

Systematic review and reconstructed time-to-event meta-analysis

Follow-up

Mean weighted follow-up was 5.05 ± 3.7 years

Authors

FFFrancesco Formica AGAlan Gallingani SDStefano D’Alessandro

Discussion

Member takes

Overview

Supports VSARR consideration for survival in suitable patients; leaves open need for RCTs to balance reoperation risk.

Study Design

Type

Meta-Analysis (n=14,651)

Structured PICO

Does valve-sparing aortic root replacement improve long-term survival compared to Bentall-De Bono in patients with aortic root dilatation and a structurally normal aortic valve?

Population

14,651 patients with aortic root dilatation and a structurally normal aortic valve undergoing Bentall-De Bono or VSARR procedures, followed for a mean of 5.05 years.

Intervention

Valve-sparing aortic root replacement (VSARR)

Comparator

Composite aortic valve-graft (Bentall-De Bono)

Outcome

Long-term survival and reoperation risk at up to 15-year follow-uphard clinical

Main Result

Hazard Ratio: 0.5 (95% CI 0.45–0.57)

p-value: p=<0.0001

Cite This Study

synapsesocial.com/papers/6aa70e724bfde8663e6df7ad https://doi.org/10.1016/j.ijcard.2024.132728

Also Consider

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