Aortic valve-sparing root replacement or Bentall?

Iannacone, Erin; Lau, Christopher; Soletti, Giovanni; Perezgrovas‐Olaria, Roberto; Harik, Lamia; Dimagli, Arnaldo; Girardi, Leonard N.

doi:10.21037/acs-2022-avs1-170

Cited by 5 publications

(3 citation statements)

References 52 publications

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“…20 This fact is justified as the procedure of valve reimplantation is technically complicated, therefore, it is associated with prolonged operative time and requires extensive dissection of modified tissues, that in this pathology in the acute period can be a difficult task even for experienced surgeons. 21 The combination of these factors dictates a specific tactical approach, particularly in patient selection for the reimplantation procedure in the context of acute aortic dissection.…”

Section: Discussionmentioning

confidence: 99%

Modified Aortic Valve Reimplantation in Patients With Acute Aortic Dissection Type A

Boldyrev,

Suslova,

Dontsova

et al. 2024

Preprint

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Background: The question of choosing surgical tactics in patients with acute aortic dissection type A unresolved to now. In patients with massive destruction of the aortic root the gold standard is the Bentall procedure. Aortic valve reimplantation is an attractive alternative, especially in patients with preserved aortic valve leaflets anatomy. Objective: To compare the results of the use of valve sparing procedure and composite root replacement in patients with acute aortic dissection type A. Methods: At the end, 62 patients were included in the study. Of those, 27 patients undervent aortic valve reimplantation and 35 had Bentall's operation in the Kouchoukos modification. Results: Preoperative demographic and clinical characteristics were such between the groups. Similar indicators of preoperative malperfusion were observed in both groups. The time of artificial circulation (p=0.125) and aortic clamping time (p=0.001) were longer in the reimplantation group, while the time of circulatory arrest was longer in the Bentall group (p=0.290). The average aortic clamping time was about 30 minutes longer in the first group. Hospital mortality in the reimplantation group was 8.3% and 22.9% in the Bentall group. Mortality from all causes in the long-term period was 6 people in the reimplantation group 25%, 10 people in the Bentall group 28.6%. The degree of aortic regurgitation did not increase in any case until the moment of extreme contact with the patient. Conclusions: Aortic valve reimplantation can be performed with good immediate and long-term results in patients with preserved aortic valve leaflets with acute aortic dissection type A.

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Section: Discussionmentioning

confidence: 99%

Modified Aortic Valve Reimplantation in Patients With Acute Aortic Dissection Type A

Boldyrev,

Suslova,

Dontsova

et al. 2024

Preprint

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show abstract

“…Nevertheless, beginning-level surgeons may feel barriers to performing the procedure because VSARR is time demanding and technically challenging. 5 Among the several important technical steps in root reimplantation is constructing uniformly spaced hemostatic layers without wrinkling the graft within a safe timeline.…”

Section: Discussionmentioning

confidence: 99%

Half back stitch for root reimplantation

Kim,

Ku,

Kim

et al. 2024

JTCVS Techniques

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“…Aortic root aneurysms pose a significant clinical challenge, often necessitating surgical intervention to mitigate the risk of catastrophic events [1,2]. While the conventional full sternotomy approach has long been the preferred method for aortic aneurysm repair, recent advancements have seen the emergence of valve-sparing techniques as endorsed by current guidelines, particularly when addressing aortic regurgitation resulting from aneurysmal widening of the aorta [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of Long-Term Outcomes in Valve-Sparing Aortic Root Reimplantation: Full Sternotomy versus Mini-Sternotomy Approach

Staromłyński,

Kowalówka,

Gocoł

et al. 2024

JCM

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Background: Aortic valve-sparing aortic root replacement (VSARR) David procedure has not been routinely performed via minimally invasive access due to its complexity. Methods: We compared our results for mini-VSARR to sternotomy-VSARR from another excellence center. Results: Eighty-four patients, 62 in the sternotomy-VSARR group and 22 in the mini-VSARR group, were included. A baseline, the aneurysm dimensions were higher in the mini-VSARR group. Propensity matching resulted in 17 pairs with comparable characteristics. Aortic cross-clamp and cardiopulmonary bypass times were significantly longer in the mini-VSARR group, by 60 and 20 min, respectively (p < 0.001). In-hospital outcomes were comparable between the groups. Drainage volumes were numerically lower, and hospital length of stay was, on average, 3 days shorter (p < 0.001) in the mini-VSARR group. At a median follow-up of 5.5 years, there was no difference in mortality (p = 0.230). Survival at 1, 5 and 10 years was 100%, 100%, and 95% and 95%, 87% and 84% in the mini-VSARR and sternotomy-VSARR groups, respectively. No repeat interventions on the aortic valve were documented. Echocardiographic follow-up was complete in 91% with excellent durability of repair regardless of the approach: no cases of moderate/severe aortic regurgitation were reported in the mini-VSARR group. Conclusions: The favorable outcomes, reduced drainage, and shorter hospital stays associated with the mini-sternotomy approach underscore its potential advantages expanding beyond cosmetic outcome.

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Aortic valve-sparing root replacement or Bentall?

Cited by 5 publications

References 52 publications

Modified Aortic Valve Reimplantation in Patients With Acute Aortic Dissection Type A

Modified Aortic Valve Reimplantation in Patients With Acute Aortic Dissection Type A

Half back stitch for root reimplantation

Comparative Analysis of Long-Term Outcomes in Valve-Sparing Aortic Root Reimplantation: Full Sternotomy versus Mini-Sternotomy Approach

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