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Updated: Jul 24, 2025

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Long-term outcomes of valve-sparing aortic root versus composite aortic valve graft replacement for aortic root
Michel Pompeu Sá1, Xander Jacquemyn2, Jef Van den Eynde2
1Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, USA; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Background:
We aimed to evaluate the long-term outcomes of valve-sparing aortic root replacement (VSARR) versus composite aortic valve graft replacement (CAVGR) for aortic root aneurysms.
Methods:
Meta-analysis of Kaplan-Meier-derived time-to-event data from studies with follow-up including propensity-score matching or propensity-score adjustment.
Results:
Six studies met our eligibility criteria, comprising 3215 patients (1770 patients treated with VSARR and 1445 patients with CAVGR). We observed a statistically significant difference for overall survival favoring VSARR (HR 0.63, 95%CI 0.49-0.82, P = 0.001), but no statistically significant difference in the risk of reoperation (HR 0.77, 95%CI 0.51-1.14, P = 0.187) in the overall follow-up. Landmark analyses revealed that, in the first 10 years after the procedure, reoperation rates were comparable between VSARR and CAVGR (HR 0.96, 95%CI 0.62-1.48, p = 0.861), but the results beyond 10 years showed improved rates of freedom from reoperation in patients undergoing VSARR (HR 0.10, 95%CI 0.01-0.78; p = 0.027).
Conclusion:
VSARR seems to confer better long-term survival and lower risk of reoperation in the follow-up of patients treated for aortic root aneurysm when compared with CAVGR.
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