Is valve-sparing root replacement a safe option in acute type A aortic dissection? A systematic review and meta-analysis

Interactive Cardiovascular and Thoracic Surgery
Jinlin WuCuntao Yu

Abstract

There are conflicting views regarding the status of valve-sparing root replacement (VSRR) as a proper treatment for acute type A aortic dissection (AAAD). Our goal was to compare the early and late outcomes of VSRR versus those of the Bentall procedure in patients with AAAD. We performed a systematic review and meta-analysis of 9 studies to compare the outcomes of VSRR with those of the Bentall procedure in patients with AAAD. We focused on the following issues: early and late mortality rates, re-exploration, thromboembolization/bleeding events, infective endocarditis and reintervention rates. A total of 706 patients with AAAD who underwent aortic root surgery were analysed; 254 patients were treated with VSRR and 452 with the Bentall procedure. VSRR was associated with a reduced risk of early death [odds ratio (OR) 0.34; 95% confidence interval (CI) 0.21-0.57] and late death (OR 0.34; 95% CI 0.21-0.57) compared with the Bentall procedure. No statistically significant difference was observed between the VSRR and Bentall groups with pooled ORs (OR 0.77; 95% CI 0.47-1.27, OR 0.61; 95% CI 0.32-1.18 and OR 0.71; 95% CI 0.23-2.15) for re-exploration, thromboembolization/bleeding and postoperative infective endocarditis, respectively...Continue Reading

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Citations

Dec 14, 2019·Current Opinion in Cardiology·Ruggero De PaulisIlaria Chirichilli
Sep 29, 2020·Journal of Cardiac Surgery·Eltayeb Mohamed Ahmed, Edward P Chen
Sep 18, 2020·Journal of Cardiac Surgery·Wahaj MunirBenjamin Adams
Oct 9, 2020·Journal of Cardiac Surgery·Marie-Catherine MorgantOlivier Bouchot
Dec 22, 2020·Journal of Cardiac Surgery·Zara KhachatryanMichael A Borger
Jan 27, 2021·Interactive Cardiovascular and Thoracic Surgery·Hulin PiaoKexiang Liu
Feb 17, 2021·Heart, Lung & Circulation·Andrei M Beliaev, Colleen J Bergin
Aug 17, 2020·Heart, Lung & Circulation·Amer HarkyAhmed Othman
May 6, 2021·Asian Cardiovascular & Thoracic Annals·Tillana Nirav TarkasBenjamin Adams

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