Valve-Sparing Root Replacement in Elderly Patients With Annuloaortic Ectasia

Area of Science:

• Cardiovascular Surgery
• Geriatric Cardiology
• Aortic Root Surgery

Background:

• Elderly patients often present with complex aortic root pathologies.
• Valve-sparing root replacement (VSRR) is an alternative to traditional valve replacement.
• Outcomes of VSRR in elderly patients require further investigation.

Purpose of the Study:

• To compare early and midterm outcomes of VSRR in elderly versus younger patients.
• To evaluate VSRR outcomes against the Bentall procedure in elderly patients.
• To assess the long-term valve function after VSRR in different age groups.

Main Methods:

• Retrospective study of 73 elderly VSRR patients (Group S), 232 younger VSRR patients (Group Y), and 45 elderly Bentall procedure patients (Group R).
• Data collected from October 1999 to October 2017.
• Preoperative aortic regurgitation severity was comparable across groups (p=0.07).

Main Results:

• Hospital mortality was low across all groups (1.4% S, 0.9% Y, 6.7% R).
• Five-year survival was significantly higher in VSRR groups (88.5% S, 98.7% Y) compared to Bentall (82.4% R, p<0.01).
• VSRR patients exhibited better valve function, with larger effective orifice area and lower gradients than Bentall procedure patients.

Conclusions:

• Elderly patients achieve comparable early and late outcomes with VSRR to younger VSRR patients.
• Valve-sparing root replacement offers superior postoperative valve performance compared to valve replacement (Bentall procedure).
• VSRR is a viable and effective option for elderly patients requiring aortic root repair.