دورية أكاديمية
Aortic valve performance after remodelling versus reimplantation in a propensity-matched comparison.
| العنوان: | Aortic valve performance after remodelling versus reimplantation in a propensity-matched comparison. |
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| المؤلفون: | Gofus J; Department of Cardiac Surgery, Faculty of Medicine and University Hospital in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic., Vojacek J; Department of Cardiac Surgery, Faculty of Medicine and University Hospital in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic., Karalko M; Department of Cardiac Surgery, Faculty of Medicine and University Hospital in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic., Zacek P; Department of Cardiac Surgery, Faculty of Medicine and University Hospital in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic., Kolesar A; Department of Cardiac Surgery, Faculty of Medicine and East Slovak Institute of Cardiovascular Disease, Pavol Jozef Šafárik University, Košice, Slovakia., Toporcer T; Department of Cardiac Surgery, Faculty of Medicine and East Slovak Institute of Cardiovascular Disease, Pavol Jozef Šafárik University, Košice, Slovakia., Urban M; Department of Cardiac Surgery, Hospital AGEL Trinec-V Podlesí, Trinec, Czech Republic., Glac F; Department of Cardiac Surgery, Hospital AGEL Trinec-V Podlesí, Trinec, Czech Republic., Cerny S; Department of Cardiac Surgery, Na Homolce Hospital, Prague, Czech Republic.; Department of Cardiovascular Surgery, University Hospital in Motol, Prague, Czech Republic., Homola P; Department of Cardiac Surgery, Na Homolce Hospital, Prague, Czech Republic., Hlubocky J; 2nd Department of Surgery, 1st Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic., Slautin A; 2nd Department of Surgery, 1st Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic., Fila P; Department of Cardiovascular Surgery and Transplantation, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Zakova D; Department of Cardiovascular Surgery and Transplantation, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Sterba J; Department of Cardiovascular Surgery and Transplantation, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Rashid H; Department of Cardiovascular Surgery, University Hospital Frankfurt and Goethe University Frankfurt, Frankfurt/Main, Germany., Van Linden A; Department of Cardiovascular Surgery, University Hospital Frankfurt and Goethe University Frankfurt, Frankfurt/Main, Germany., Holubec T; Department of Cardiovascular Surgery, University Hospital Frankfurt and Goethe University Frankfurt, Frankfurt/Main, Germany. |
| المصدر: | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2024 Aug 02; Vol. 66 (2). |
| نوع المنشور: | Journal Article; Multicenter Study; Comparative Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: Germany NLM ID: 8804069 Publication Model: Print Cited Medium: Internet ISSN: 1873-734X (Electronic) Linking ISSN: 10107940 NLM ISO Abbreviation: Eur J Cardiothorac Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2012-: Oxford, England : Oxford University Press Original Publication: [Berlin] : Springer International ; [Secaucus, NJ, USA : Springer-Verlag New York Inc., distributor, c1987- |
| مواضيع طبية MeSH: | Propensity Score* , Aortic Valve*/surgery , Replantation*/methods , Aortic Valve Insufficiency*/surgery, Humans ; Male ; Retrospective Studies ; Female ; Middle Aged ; Aged ; Reoperation/statistics & numerical data ; Treatment Outcome ; Heart Valve Prosthesis Implantation/methods ; Cardiac Valve Annuloplasty/methods ; Adult |
| مستخلص: | 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. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.) |
| معلومات مُعتمدة: | Cooperatio, area Cardiovascular science |
| فهرسة مساهمة: | Keywords: Aortic regurgitation; Aortic root aneurysm; Aortic valve repair; Propensity-score matching; Valve-sparing root replacement |
| تواريخ الأحداث: | Date Created: 20240805 Date Completed: 20240805 Latest Revision: 20240805 |
| رمز التحديث: | 20240806 |
| DOI: | 10.1093/ejcts/ezae234 |
| PMID: | 39102871 |
| قاعدة البيانات: | MEDLINE |
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