J 2024

Aortic valve performance after remodelling versus reimplantation in a propensity-matched comparison

GOFUS, Jan; Jan VOJACEK; Mikita KARALKO; Pavel ZACEK; Adrian KOLESAR et al.

Základní údaje

Originální název

Aortic valve performance after remodelling versus reimplantation in a propensity-matched comparison

Autoři

GOFUS, Jan; Jan VOJACEK; Mikita KARALKO; Pavel ZACEK; Adrian KOLESAR; Tomas TOPORCER; Martin URBAN; Filip GLAC; Stepan CERNY; Pavel HOMOLA; Jaroslav HLUBOCKY; Andrey SLAUTIN; Petr FILA; Daniela ŽÁKOVÁ; Jan ŠTĚRBA; Hiwad RASHID; Arnaud VAN LINDEN a Tomas HOLUBEC

Vydání

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, CARY, OXFORD UNIV PRESS INC, 2024, 1010-7940

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 3.000

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/24:00136840

Organizační jednotka

Lékařská fakulta

EID Scopus

Klíčová slova anglicky

Aortic valve repair; Valve-sparing root replacement; Aortic root aneurysm; Aortic regurgitation; Propensity-score matching

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 19. 8. 2024 08:28, Mgr. Tereza Miškechová

Anotace

V originále

OBJECTIVES: Both aortic root remodelling and aortic valve (AV) reimplantation have been used for valve-sparing root replacement in patients with aortic root aneurysm with or without aortic regurgitation. There is no clear evidence to support one technique over the another. This study aimed to compare remodelling with basal ring annuloplasty versus reimplantation on a multicentre level with the use of propensity-score matching. METHODS: This was a retrospective international multicentre study of patients undergoing remodelling or reimplantation between 2010 and 2021. Twenty-three preoperative covariates (including root dimensions and valve characteristics) were used for propensity-score matching. Perioperative outcomes were analysed along with longer-term freedom from AV reoperation/reintervention and other major valve-related events. RESULTS: Throughout the study period, 297 patients underwent remodelling and 281 had reimplantation. Using propensity-score matching, 112 pairs were selected and further compared. We did not find a statistically significant difference in perioperative outcomes between the matched groups. Patients after remodelling had significantly higher reintervention risk than after reimplantation over the median follow-up of 6 years (P = 0.016). The remodelling technique (P = 0.02), need for decalcification (P = 0.03) and degree of immediate postoperative AV regurgitation (P < 0.001) were defined as independent risk factors for later AV reintervention. After exclusion of patients with worse than mild AV regurgitation immediately after repair, both techniques functioned comparably (P = 0.089). CONCLUSIONS: AV reimplantation was associated with better valve function in longer-term postoperatively than remodelling. If optimal immediate repair outcome was achieved, both techniques provided comparable AV function.