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A Systemic Review and Meta-Analysis: Bentall Versus David Procedure in Acute Type A Aortic Dissection

Submitted by: Claire Vernon

Source: European Journal of Cardio-Thoracic Surgery

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Author(s): Selim Mosbahi, Dushaj Stak, Isaac Gravestock, Jakob M Burgstaller, Johann Steurer, Friedrich Eckstein, Enrico Ferrari, Denis A Berdajs

In this systemic review and meta-analysis, the authors compared outcomes for patients undergoing aortic root replacement to those undergoing a David operation. Mosbahi and colleagues analyzed 27 studies that included a total of 3058 patients with acute type A aortic dissections. In-hospital mortality and midterm survival both favored aortic valve reimplantation. Freedom from valve-related reintervention was 100% (confidence interval (CI) 93.7 – 100%) in patients who underwent reimplantation compared to 94.6% (CI 86.7 – 99.1%) for a composite valve graft intervention. The authors conclude that in type A dissection the reimplantation procedure (David operation) provided a superior outcome.

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