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Twenty-year follow-up after valve-sparing aortic root replacement with the Yacoub or David procedure in Marfan patients.

ABSTRACT:

SUBMITTER: Jahanyar J

PROVIDER: S-EPMC9390185 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature

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Twenty-year follow-up after valve-sparing aortic root replacement with the Yacoub or David procedure in Marfan patients.

Jahanyar Jama J de Kerchove Laurent L Munoz Daniel E DE El Khoury Gebrine G

JTCVS open 20210721

PMID: 36003717

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Project description:BackgroundCurrent guidelines recommend valve-sparing aortic root replacement (VSRR) procedures over valve replacement for the treatment of root aneurysm. The reimplantation technique seems to be the most widely used valve-sparing technique, with excellent outcomes in mostly single-center studies. The aim of this systematic review and meta-analysis is to present a comprehensive overview of clinical outcomes after VSRR with the reimplantation technique, and potential differences for bicuspid aortic valve (BAV) phenotype.MethodsWe conducted a systematic literature search of papers reporting outcomes after VSRR that were published since 2010. Studies solely reporting on acute aortic syndromes or congenital patients were excluded. Baseline characteristics were summarized using sample size weighting. Late outcomes were pooled using inverse variance weighting. Pooled Kaplan-Meier (KM) curves for time-to-event outcomes were generated. Further, a microsimulation model was developed to estimate life expectancy and risks of valve-related morbidity after surgery.ResultsForty-four studies, with 7,878 patients, matched the inclusion criteria and were included for analysis. Mean age at operation was 50 years and almost 80% of patients were male. Pooled early mortality was 1.6% and the most common perioperative complication was chest re-exploration for bleeding (5.4%). Mean follow-up was 4.8±2.8 years. Linearized occurrence rates for aortic valve (AV) related complications such as endocarditis and stroke were below 0.3% patient-year. Overall survival was 99% and 89% at 1- and 10-year respectively. Freedom from reoperation was 99% and 91% after 1 and 10 years, respectively, with no difference between tricuspid and BAVs.ConclusionsThis systematic review and meta-analysis shows excellent short- and long-term results of valve-sparing root replacement with the reimplantation technique in terms of survival, freedom from reoperation, and valve related complications with no difference between tricuspid and BAVs.

Dataset Information

Twenty-year follow-up after valve-sparing aortic root replacement with the Yacoub or David procedure in Marfan patients.

Publications

Twenty-year follow-up after valve-sparing aortic root replacement with the Yacoub or David procedure in Marfan patients.

Similar Datasets

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