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Updated: Jan 17, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

Aortic valve-sparing root replacement and composite root replacement: a Danish multicentre nationwide study.

Emil Johannes Ravn^1,2, Lytfi Krasniqi^1,3, Viktor Poulsen¹

¹Department of Cardiothoracic Surgery, Odense University Hospital, Winsløwsvej 4, 5000 Odense C, Odense, Denmark.

European Heart Journal Open

|September 22, 2025

Summary

Aortic valve-sparing root replacement offers better long-term survival and reduced stroke risk compared to composite root replacement in nationwide settings. This study supports its use as a durable option for aortic root aneurysm repair.

Keywords:

Aortic root replacement Aortic valve-sparing root replacement Composite root replacement Long-term outcomes

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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

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Published on: March 26, 2018

Area of Science:

Cardiovascular Surgery
Aortic Aneurysm Research
Surgical Outcomes Analysis

Background:

Aortic root aneurysms often necessitate surgical intervention.
Aortic valve-sparing root replacement (AVSRR) is increasingly favored over composite root replacement (CRR), particularly in younger patients.
However, long-term outcomes of AVSRR versus CRR in low-volume national settings require further investigation.

Purpose of the Study:

To compare the long-term survival, stroke incidence, and reoperation rates between AVSRR and CRR for aortic root aneurysms.
To evaluate the durability and safety of AVSRR in a nationwide, low-volume setting.

Main Methods:

Retrospective analysis of 760 patients undergoing CRR and 179 patients undergoing AVSRR from Danish national registries (2010-2022).
Propensity score matching was employed to balance baseline characteristics between the two groups.
Primary outcome was all-cause mortality; secondary outcomes included stroke, reoperation, and aortic regurgitation.

Main Results:

After matching 157 patients per group, AVSRR demonstrated significantly improved 10-year survival (91.2% vs. 80.4%, P=0.026) and lower 10-year stroke risk (4.9% vs. 18.9%, P=0.007).
No significant difference in reoperation risk was observed between the groups (P=0.12).
Patients undergoing CRR were younger but had higher comorbidity scores (EuroSCOREII).

Conclusions:

Aortic valve-sparing root replacement is associated with superior long-term survival and reduced stroke risk compared to composite root replacement in a nationwide, low-volume setting.
AVSRR represents a durable and effective surgical option for selected patients with aortic root aneurysms.
These findings support the broader adoption of AVSRR for appropriate patient populations.