Midterm outcomes of concomitant ascending aorta replacement with rapid deployment aortic valve replacement

Aortic valve replacement (AVR) frequently accompanies concomitant ascending aorta replacement. This study was conducted to evaluate the early and midterm outcomes of patients who underwent AVR with rapid-deployment valve (RDAVR) and concomitant ascending aorta replacement compared to those who underwent isolated RDAVR.

From June 2016 to June 2023, 130 patients who underwent RDAVR with concomitant ascending aorta replacement (Ao-AVR group) and 108 patients who underwent isolated RDAVR (Iso-AVR group) were enrolled in this study. Early and midterm outcomes were compared between the groups. Multivariate analysis was performed to identify the risk factors associated with all-cause mortality.

Ao-AVR group was younger and less morbid than Iso-AVR group. Bicuspid aortic valvulopathy was the main etiology in Ao-AVR group (71.5%), whereas degenerative calcific valvulopathy was the main etiology in Iso-AVR group (55.6%). Cardiopulmonary bypass time and aortic cross-clamp time were 21 and 28 minutes longer, respectively, in Ao-AVR group. Operative mortality was 0.0% in Ao-AVR group, and their early clinical outcomes were comparable to those of Iso-AVR group, except for the occurrence of postoperative atrial fibrillation (46.9% vs. 34.3%, P=0.048). Multivariate analysis demonstrated that age, chronic obstructive pulmonary disease, and emergency operation were the significant risk factors associated with midterm all-cause mortality, whereas concomitant ascending aorta replacement was not a risk factor.

Concomitant ascending aorta replacement during RDAVR demonstrated excellent early and midterm outcomes, comparable to isolated RDAVR.