Homograft implantation techniques in the aortic position: to preserve or replace the aortic root?

The Annals of Thoracic Surgery
Thanos AthanasiouDonald N Ross

Abstract

One determinant of durability of the homograft in the aortic position is the implantation technique. This study uses meta-analytical techniques to evaluate the differences in early and long-term outcomes of patients undergoing aortic homograft implantation with either a root replacement or a root preserving technique. A systematic review of the literature (1965-2005) reporting results after homograft implantation in the aortic position with emphasis in the implantation technique was performed. Random and fixed-effects models were used. Cumulative and influential meta-analysis, graphic exploration, and sensitivity analysis were carried out to explain the heterogeneity between studies and to investigate potential publication bias. Eleven studies were included. None of the studies was randomized. There was no significant difference in early mortality between root replacement and root preserving groups (odds ratio = 2.57 with 95% confidence interval [CI] 0.68-9.72 in random-effects model) and the root replacement group had a significantly lower rate of reoperation during long-term follow-up (hazard ratio = 0.55 with 95% CI 0.38-0.80 in random-effects model). Subgroup analysis focusing on patients having the subcoronary technique fo...Continue Reading

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Citations

May 25, 2013·The Annals of Thoracic Surgery·Lars G SvenssonMathew R Williams
Jan 8, 2013·The Annals of Thoracic Surgery·Lars G SvenssonMathew R Williams
Feb 3, 2009·The Journal of Thoracic and Cardiovascular Surgery·Ayyaz AliJohn Pepper
Apr 25, 2006·The Annals of Thoracic Surgery·Tirone E David
Feb 23, 2010·The Annals of Thoracic Surgery·Rachid ZegdiJean-Noël Fabiani
Nov 27, 2007·The Annals of Thoracic Surgery·Jean-François AvierinosAlberto Riberi
Oct 8, 2016·Annals of Cardiac Anaesthesia·Arindam ChoudhuryP Rajashekar
Jan 13, 2021·The Annals of Thoracic Surgery·Farhang YazdchiTsuyoshi Kaneko

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