Long-term outcomes of aortic root operations for XXXX : A comparison of Bentall versus aortic valve-sparing procedures.

@entity1 @entity449 @entity1614 @entity337 @entity1031 @entity1580 @entity884
OBJECTIVES: Prophylactic aortic root replacement improves survival in @entity1 with @entity1614 with @entity449 , but the optimal procedure remains undefined. METHODS: Adult @entity1 with @entity1614 who had Bentall or aortic valve-sparing root replacement (VSRR) procedures between 1997 and 2013 were identified. Comprehensive follow-up information was obtained from hospital charts and telephone contact. RESULTS: One hundred sixty-five adult @entity1 with @entity1614 (aged  >  20  years) had either VSRR (n  =  98; 69 reimplantation, 29 remodeling) or Bentall (n  =  67) procedures. @entity1 undergoing Bentall procedure were older (median, 37 vs 36  years; P  =  .03), had larger median preoperative sinus diameter (5.5  cm vs 5.0  cm; P  =  .003), more @entity1580 (25.4% vs 4.1%; P  <  .001), higher incidence of moderate or severe @entity337 (49.3% vs 14.4%; P  <  .001) and more urgent or emergent operations (24.6% vs 3.3%; P  <  .001). There were no hospital deaths and 9 late deaths in more than 17  years of follow-up (median, 7.8 deaths). Ten-year survival was 90.5% in @entity1 undergoing Bentall procedure and 96.3% in @entity1 undergoing VSRR (P  =  .10). Multivariable analysis revealed that VSRR was associated with fewer @entity1031 or hemorrhagic events (hazard ratio, 0.16; 95% confidence interval, 0.03-0.85; P  =  .03). There was no independent difference in long-term survival, freedom from reoperation, or freedom from @entity884 between the 2 procedures. CONCLUSIONS: After prophylactic root replacement in @entity1 with @entity1614 , @entity1 undergoing Bentall and valve-sparing procedures have similar late survival, freedom from root reoperation, and freedom from @entity884 . However, valve-sparing procedures result in significantly fewer @entity1031 and hemorrhagic events.
