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July 4, 2019Interactive Cardiovascular and Thoracic Surgery

Valve-sparing root replacement reduces early death ~66% and lowers late mortality versus Bentall in ATAAD.

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Why the study?

Conflicting views exist regarding the status of valve-sparing root replacement as a proper treatment for acute type A aortic dissection.

Does valve-sparing root replacement improve mortality compared to the Bentall procedure in patients with acute type A aortic dissection?

Population

706 patients with AAAD undergoing aortic root surgery across 9 studies

Comparison

Valve-sparing root replacement vs Bentall procedure

Design

Systematic review and meta-analysis

Key result

Valve-sparing root replacement significantly reduced the risk of early death (OR 0.34; 95% CI 0.21-0.57) and late death compared to the Bentall procedure in acute type A aortic dissection.

Authors

JWJinlin WuYHYan HuangJQJuntao Qiu

Discussion

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Member takes

Overview

May favor valve-sparing root replacement over Bentall for lower mortality in acute type A dissection; leaves open durability and RCT confirmation.

Study Design

Type

Meta-Analysis (n=706)

Structured PICO

Does valve-sparing root replacement improve mortality compared to the Bentall procedure in patients with acute type A aortic dissection?

P
Population
706 patients with acute type A aortic dissection who underwent aortic root surgery (254 VSRR, 452 Bentall procedure) across 9 studies.
I
Intervention
Valve-sparing root replacement (VSRR)
C
Comparator
Bentall procedure
O
Outcome
Early and late mortality rateshard clinical

Main Result

Odds Ratio: 0.34 (95% CI 0.21–0.57)

Valve-sparing root replacement in acute type A aortic dissection is associated with lower early and late mortality compared to the Bentall procedure, despite a higher risk of reintervention.

Cite This Study

Wu et al. (2019) conducted a meta-analysis in Acute type A aortic dissection (AAAD) (n=706). Valve-sparing root replacement (VSRR) vs. Bentall procedure was evaluated on Early death (OR 0.34, 95% CI 0.21-0.57). Valve-sparing root replacement significantly reduced the risk of early death (OR 0.34; 95% CI 0.21-0.57) and late death compared to the Bentall procedure in acute type A aortic dissection.

synapsesocial.com/papers/6aa70e724bfde8663e6df7b3https://doi.org/10.1093/icvts/ivz180
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Also Consider

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

  1. 1Clinical outcomes of valve-sparing root replacement in acute type A aortic dissection2015 · 11 citations
  2. 2Comparison of Outcomes between Valve-Sparing Root Replacement and the Bentall Procedure in Acute Stanford Type A Aortic Dissection: A Single-Center Retrospective Cohort Study in South Korea2026
  3. 3Comparing outcomes between valve-sparing root replacement and the Bentall procedure in proximal aortic aneurysms: systematic review and meta-analysis2019 · 32 citations
  4. 4Repair of aortic root in patients with aneurysm or dissection: comparing the outcomes of valvesparing root replacement with those from the Bentall procedure2013 · 18 citations
  5. 5The mid-term outcomes of aortic-root repair is not inferior to Bentall procedure in acute type-A aortic dissection2023 · 6 citations