Durability and survival following valve-sparing root replacement: a longitudinal study.

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Aortic Surgery

Background:

• Dilated aortic roots pose significant risks, including aortic dissection and rupture.
• Traditional aortic root replacement often necessitates lifelong anticoagulation.
• Valve-sparing root replacement (VSRR) aims to preserve native aortic valve function.

Purpose of the Study:

• To evaluate the immediate and long-term outcomes of valve-sparing root replacement (VSRR).
• To assess survival rates and complication profiles following VSRR in patients with dilated aortic roots.
• To determine the efficacy of VSRR in managing aortic root pathologies.

Main Methods:

• An observational study included 91 patients undergoing VSRR from June 2009 to October 2024.
• Data collected included demographics, pre-operative characteristics, surgical details, and valve morphology.
• Primary outcome was all-cause mortality; secondary outcomes included valve-related complications and reintervention rates.

Main Results:

• The cohort (mean age 38.5 years) predominantly had aortic aneurysms (91.2%) and moderate-severe aortic regurgitation (80.2%).
• 30-day mortality was 3.2%. Mean survival was 12.7 years, with 10-year survival at 86%.
• Freedom from moderate/severe aortic regurgitation at 5 years was 77%. Surgical complications were low.

Conclusions:

• VSRR demonstrates excellent long-term survival rates.
• The procedure is associated with low complication and reintervention rates.
• VSRR is a viable and effective surgical approach for patients with aortic root pathologies.