Amer Harky1, Matthew Fok2, Saied Froghi3, Haris Bilal4, Mohamad Bashir4,51Department of Vascular Surgery, Countess of Chester Hospital, Chester, United Kingdom
2Department of Surgery, Peterborough City Hospital, Edith Cavell Campus, Peterborough, United Kingdom
3Department of General Surgery, Imperial College Healthcare NHS Trust, St. Mary’s Hospital, London, United Kingdom
4Manchester Aortovascular Institute, Manchester Metropolitan University, Manchester, United Kingdom
5Electronic correspondence: firstname.lastname@example.org
Background and aim of the study: Aortic root aneurysms represent a significant risk of morbidity and mortality. Composite root replacement is the preferred practice for repair, although recently valve-sparing replacement has become a popular alternative. The study aim was to identify comparative studies that simultaneously analyzed composite root and valve-sparing root replacement outcomes.
Methods: A systematic review of the current literature was performed through four major databases, from inception until 2016. All comparative studies of valve-sparing versus composite root replacement were identified. All studies were assessed by two reviewers for their applicability and inclusion.
Results: A total of 12 comparative papers was identified
encompassing 2,352 patients (700 valve-sparing and 1,652 composite); the mean follow up was 3.7 ± 1.7 years. Aortic cross-clamp and cardiopulmonary bypass times were lower in the composite group (p <0.0001 and p<0.00001, respectively). In-hospital mortality was low, but higher in the composite group (p = 0.002). Only one study reported long-term follow up. In studies reporting reoperation, there was slight difference favoring composite over valve-sparing replacement (p = 0.05).
Conclusion: Valve-sparing and composite root replacement remain feasible options for replacement of the aortic root. Long-term data of comparative studies are not yet available to assess the viability of these procedures.
The Journal of Heart Valve Disease 2017;26:632-638
|Valve-Sparing Aortic Root Repair Compared to Composite Aortic Root Replacement: A Systematic Review and Meta-Analysis|
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