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A Comparison of Two Strategies for Aortic Valve-sparing Root Replacement

Sunday, August 11, 2019

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Source Name: The Annals of Thoracic Surgery


Erik Beckmann, Alessandro Leone, Andreas Martens, Carlo Mariani, Heike Krueger, Serghei Cebotari, Roberto Di Bartolomeo, Axel Haverich, Malakh Lal Shrestha, Davide Pacini

Colleagues from Italy and Germany compared the short- and mid-term outcomes of the straight tube graft (David-I) and the Valsalva graft in 232 patients undergoing an isolated David procedure. The two groups did not differ significantly in 30-day mortality (1% vs 2%), late survival (p = 0.799), or valve-related reoperation (p = 0.241). Although with more cusp repairs (22% vs 4%), patients with Valsalva graft showed a higher incidence of aortic insufficiency ≥ II° after surgery (17% vs 0%) and at follow-up (39% vs 22%). This study also identified bicuspid aortic valve (OR = 3.435, p = 0.005) and postoperative aortic insufficiency ≥ II° (OR = 5.988, p < 0.001) as risk factors for reoperation on the aortic valve.


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