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

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.

Basic information

Original name

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

Authors

GOFUS, Jan (203 Czech Republic), Jan VOJACEK (203 Czech Republic), Mikita KARALKO, Pavel ZACEK (203 Czech Republic), Adrian KOLESAR (203 Czech Republic), Tomas TOPORCER (203 Czech Republic), Martin URBAN (203 Czech Republic), Filip GLAC (203 Czech Republic), Stepan CERNY (203 Czech Republic), Pavel HOMOLA (203 Czech Republic), Jaroslav HLUBOCKY (203 Czech Republic), Andrey SLAUTIN, Petr FILA (203 Czech Republic, belonging to the institution), Daniela ŽÁKOVÁ (203 Czech Republic, belonging to the institution), Jan ŠTĚRBA (203 Czech Republic, belonging to the institution), Hiwad RASHID, Arnaud VAN LINDEN and Tomas HOLUBEC (203 Czech Republic)

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 3.400 in 2022

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1093/ejcts/ezae234

UT WoS

001284515800001

Keywords in English

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

Abstract

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.

Citovat

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 and Tomas HOLUBEC. Aortic valve performance after remodelling versus reimplantation in a propensity-matched comparison. EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. CARY: OXFORD UNIV PRESS INC, 2024, vol. 66, No 2, p. 1-9. ISSN 1010-7940. Available from: https://dx.doi.org/10.1093/ejcts/ezae234.

@article{2423719,
   author = {Gofus, Jan and Vojacek, Jan and Karalko, Mikita and Zacek, Pavel and Kolesar, Adrian and Toporcer, Tomas and Urban, Martin and Glac, Filip and Cerny, Stepan and Homola, Pavel and Hlubocky, Jaroslav and Slautin, Andrey and Fila, Petr and Žáková, Daniela and Štěrba, Jan and Rashid, Hiwad and Van Linden, Arnaud and Holubec, Tomas},
   article_location = {CARY},
   article_number = {2},
   doi = {http://dx.doi.org/10.1093/ejcts/ezae234},
   keywords = {Aortic valve repair; Valve-sparing root replacement; Aortic root aneurysm; Aortic regurgitation; Propensity-score matching},
   language = {eng},
   issn = {1010-7940},
   journal = {EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY},
   title = {Aortic valve performance after remodelling versus reimplantation in a propensity-matched comparison},
   url = {https://academic.oup.com/ejcts/article/66/2/ezae234/7727652?login=true},
   volume = {66},
   year = {2024}
}

TY  - JOUR
ID  - 2423719
AU  - Gofus, Jan - Vojacek, Jan - Karalko, Mikita - Zacek, Pavel - Kolesar, Adrian - Toporcer, Tomas - Urban, Martin - Glac, Filip - Cerny, Stepan - Homola, Pavel - Hlubocky, Jaroslav - Slautin, Andrey - Fila, Petr - Žáková, Daniela - Štěrba, Jan - Rashid, Hiwad - Van Linden, Arnaud - Holubec, Tomas
PY  - 2024
TI  - Aortic valve performance after remodelling versus reimplantation in a propensity-matched comparison
JF  - EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
VL  - 66
IS  - 2
SP  - 1-9
EP  - 1-9
PB  - OXFORD UNIV PRESS INC
SN  - 10107940
KW  - Aortic valve repair
KW  - Valve-sparing root replacement
KW  - Aortic root aneurysm
KW  - Aortic regurgitation
KW  - Propensity-score matching
UR  - https://academic.oup.com/ejcts/article/66/2/ezae234/7727652?login=true
N2  - 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.
ER  -

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 and Tomas HOLUBEC. Aortic valve performance after remodelling versus reimplantation in a propensity-matched comparison. \textit{EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY}. CARY: OXFORD UNIV PRESS INC, 2024, vol.~66, No~2, p.~1-9. ISSN~1010-7940. Available from: https://dx.doi.org/10.1093/ejcts/ezae234.

Detailed Information on Publication Record