Mid-Term Results of Aortic Valve Preservation: Remodelling vs. Reimplantation

Tp, Graeter; Aicher, Diana; Langer, Frank; Wendler, Olaf; Hj, Schäfers

doi:10.1055/s-2002-20159

Cited by 17 publications

(19 citation statements)

References 18 publications

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“…The initial screen of for this analysis identified 251 citations. A comparison between reimplantation and remodeling technique was provided by 18 studies 9‐15 . Of these, nine duplicate reports 16–24 and two studies 25,26 in which the patient number of one group is less than 5 were excluded.…”

Section: Resultsmentioning

confidence: 99%

“…Of these, nine duplicate reports 16–24 and two studies 25,26 in which the patient number of one group is less than 5 were excluded. At last, a total of seven studies reported involving 672 patients met the inclusion criteria for this analysis 9–15 …”

Section: Resultsmentioning

confidence: 99%

“…Three series (369 patients) provided data regarding CPB and aortic clamping time 10,12,13 . The pooled effect size estimate suggested that the CPB time was increased by 14.05 min in the reimplantation group (95% CI 6.14 to 21.95; p = 0.0005).…”

Section: The Cardiopulmonary Bypass and Aortic Clamping Timementioning

confidence: 99%

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Reimplantation Versus Remodeling: A Meta-Analysis

Liu

Wang

et al. 2011

Journal of Cardiac Surgery

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Reimplantation Versus Remodeling: A Meta-Analysis

Liu

Wang

et al. 2011

Journal of Cardiac Surgery

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“…In several series, the freedom from moderate or severe AI within the follow-up period was more frequent for the David compared to the Yacoub technique [4,[7][8][9][10][11][12]15], although this seldom reached statistical significance [4,11]. The selection criteria for each technique are not well established.…”

Section: Resultsmentioning

confidence: 99%

Aortic valve-sparing operations in aortic root aneurysms: remodeling or reimplantation?

Rahnavardi

Yan

Bannon

et al. 2011

Interactive CardioVascular and Thoracic Surgery

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A best evidence topic was written according to a structured protocol. The question addressed was whether the reimplantation (David) technique or the remodeling (Yacoub) technique provides the optimum event free survival in patients with an aortic root aneurysm suitable for an aortic valve-sparing operation. In total, 392 papers were found using the reported search criteria, of which 14 papers provided the best evidence to answer the clinical question. A total of 1338 patients (Yacoub technique in 606 and David technique in 732) from 13 centres were included. In most series, cardiopulmonary bypass time and aortic cross-clamp time were longer for the David technique compared to the Yacoub technique. Early mortality was comparable between the two techniques (0-6.9% for the Yacoub technique and 0-6% for the David technique). There is a tendency for a higher freedom from significant long-term aortic insufficiency in the David group than the Yacoub group, which does not necessarily result in a higher reoperation rate in the Yacoub group. In the largest series reported, freedom from a moderate-to-severe aortic insufficiency at 12 years was 82.6 ± 6.2% in the Yacoub and 91.0 ± 3.8% in the David group (P=0.035). Freedom from reoperation at the same time point was 90.4 ± 4.7% in the Yacoub group and 97.4 ± 2.2% in the David group (P=0.09). In another series, freedom from reoperation at a follow-up time of about four years was 89 ± 4% in the Yacoub group and 98 ± 2% in the David group. Although some authors merely preferred the Yacoub technique for a bicuspid aortic valve, the accumulated evidence in the current review indicates comparable results for both techniques in a bicuspid aortic valve. Current evidence is in favour of the David rather than the Yacoub technique in pathologies such as Marfan syndrome, acute type A aortic dissection, and excessive annular dilatation that may impair aortic root integrity. Careful selection of patients for each technique and successful restoration of normal cusp geometry are the keys to success in aortic valve-sparing operations.

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“…Interestingly, the Toronto group has reported higher freedom from recurrent AR after bicuspid aortic valve repair associated with reimplantation than after valve repair alone (31). Repair associated with remodeling has also produced good results (32). Repair durability.…”

Section: Cuspsmentioning

confidence: 99%