April 5, 2022Journal of Cardiac Surgery
Valve‐sparing versus valve‐replacing aortic root replacement in patients with aortic root aneurysm
Key result
VSARR is linked to ~11% higher 8-year survival compared to VRARR.
- P=0.025
- n=475
Why the study?
Valve-sparing aortic root replacement is an alternative to valve-replacing aortic root replacement with valved-conduits based on recent guidelines, motivating an investigation into outcomes between these two procedures in patients with nonstenotic valves.
Does valve-sparing aortic root replacement improve survival and reduce reoperation compared to valve-replacing aortic root replacement in patients with aortic root aneurysm without aortic stenosis?
Population
475 patients with aortic root aneurysm without aortic stenosis
Comparison
VSARR vs VRARR
Design
Propensity score-matched cohort study
Follow-up
8-year
Authors
Discussion
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Member takes
Implication
May support valve-sparing preference in suitable nonstenotic cases; leaves open need for randomized confirmation.
Study Design
Type
Cohort (n=475)
Structured PICO
Does valve-sparing aortic root replacement improve survival and reduce reoperation compared to valve-replacing aortic root replacement in patients with aortic root aneurysm without aortic stenosis?
P
Population
475 patients with aortic root aneurysm and nonstenotic valves undergoing valve-sparing or valve-replacing aortic root replacement, evaluated using 69 propensity-matched pairs over 8 years.
E
Exposure
Valve-sparing aortic root replacement (VSARR)
C
Comparator
Valve-replacing aortic root replacement (VRARR) with valved-conduits
O
Outcome
30-day mortality, 8-year survival and reoperation, aortic regurgitation, and valve gradientshard clinical
Main Result
Absolute Event Rate: 100% vs 88.9%
p-value: p=0.025
Valve-sparing aortic root replacement is associated with improved 8-year survival and better valve hemodynamics compared to valve-replacing techniques in patients with aortic root aneurysm and nonstenotic valves.
Cite This Study
Malaisrie et al. (2022) conducted a cohort in Aortic root aneurysm without aortic stenosis (n=475). Valve-sparing aortic root replacement (VSARR) vs. Valve-replacing aortic root replacement (VRARR) was evaluated on Overall survival (p=0.025). Valve-sparing aortic root replacement was associated with significantly higher 8-year overall survival compared to valve-replacing aortic root replacement (100% vs. 88.9%; p=0.025).