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Titel: Outcomes of valve-sparing surgery in heritable aortic disorders : results from the AVIATOR registry
VerfasserIn: Chauvette, Vincent
Kluin, Jolanda
de Kerchove, Laurent
El Khoury, Gebrine
Schäfers, Hans-Joachim
Lansac, Emmanuel
El-Hamamsy, Ismail
Sprache: Englisch
Titel: European Journal of Cardio-Thoracic Surgery
Bandnummer: 62
Heft: 3
Verlag/Plattform: Oxford University Press
Erscheinungsjahr: 2022
Freie Schlagwörter: Valve sparing
Heritable aortic disorders
Aneurysm
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Root reimplantation has been the favoured approach for patients with heritable aortic disorder requiring valve-sparring root replacement. In the past few years, root remodelling with annuloplasty has emerged as an alternative to root reimplantation in the general population. The aim of this study was to examine the late outcomes of patients with heritable aortic disorder undergoing valve-sparring root replacement and compare different techniques. METHODS Using the AVIATOR registry (Aortic Valve Insufficiency and ascending aorta Aneurysm InternATiOnal Registry), data were collected from 5 North American and European centres. Patients were divided into 4 groups according to the technique of valve-sparing used (root reimplantation, root remodelling with ring annuloplasty, root remodelling with suture annuloplasty and root remodelling alone). The primary endpoints were freedom from aortic regurgitation (AR) ≥2 and freedom from reintervention on the aortic valve. Secondary endpoints were survival and changes in annular dimensions over time. RESULTS A total of 237 patients were included in the study (reimplantation = 100, remodelling + ring annuloplasty = 76, remodelling + suture annuloplasty = 34, remodelling alone = 27). The majority of patients had Marfan syndrome (83%). Preoperative AR ≥2 was present in 41% of the patients. Operative mortality was 0.4% (n = 1). No differences were found between techniques in terms of postoperative AR ≥2 (P = 0.58), reintervention (P = 0.52) and survival (P = 0.59). Changes in aortic annulus dimension were significantly different at 10 years (P < 0.05), a difference that started to emerge 4 years after surgery. CONCLUSIONS Overall, valve-sparring root replacement is a safe and durable procedure in patients with heritable aortic disorder. Nevertheless, root remodelling alone is associated with late annular dilatation. The addition of an annuloplasty, however, results in similar freedom from AR, reintervention, survival and changes in annulus size compared to reimplantation.
DOI der Erstveröffentlichung: 10.1093/ejcts/ezac366
URL der Erstveröffentlichung: https://doi.org/10.1093/ejcts/ezac366
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-385644
hdl:20.500.11880/34756
http://dx.doi.org/10.22028/D291-38564
ISSN: 1873-734X
1010-7940
Datum des Eintrags: 13-Dez-2022
Bezeichnung des in Beziehung stehenden Objekts: Supplementary Material
In Beziehung stehendes Objekt: https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/ejcts/62/3/10.1093_ejcts_ezac366/2/ezac366_supplementary_data.zip?Expires=1672908866&Signature=Nq1nkXhZ1O3sBWSsGxX5VVlRR-N677aUkStL5oz7PsrGrqv17i1favu1Rq33thB-Lq9OYRUfEXnGS3nOEyp9acrO120Fiediva4G0vpjF81CsmrMzAtZ-UuA9O-a5gC-En1B1ZCaENKo6qtMnbU0pYK9-mMs~vksEZywOyPmuCnswUrUd19aFEMhtrf~3SV8QuQzJjCInr7GR2psd2VtknSUDtxrHq82b2ZqLCm7SHAwEfeMTMrah4U5YDBDkiKbk6WPxhyPZSQpat-E0Ol9poFMj8k-I09o2KDXjOr~oMLUFMazrU6gYIWeQnuID26nFazqwDYSVAvhUWzzNrQwjw__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Chirurgie
Professur: M - Prof. Dr. Hans Joachim Schäfers
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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