Reported Outcome After Valve-Sparing Aortic Root Replacement for XXXX : A Systematic Review and Meta-Analysis.

@entity1 @entity449 @entity337
UNASSIGNED: Valve-sparing aortic root techniques have progressively gained ground in the treatment of @entity449 and @entity337 . By avoiding anticoagulation therapy they offer a good alternative to composite graft replacement. This systematic review describes the reported outcome of valve-sparing aortic root replacement, focusing on the remodeling and reimplantation technique. A systematic literature search on the characteristics of and outcomes after valve-sparing aortic root replacement revealed 1,659 articles. The inclusion criteria were a focus on valve-sparing aortic root replacement in adults with @entity449 , presentation of survival data, and inclusion of at least 30 @entity1 . Data were pooled by inverse variance weighting and analyzed by linear regression. Of 1,659 articles published between January 1, 2000, and January 1, 2014, 31 were included (n  = 4,777 @entity1 ). The mean age at operation was 51    14.7 years, and 14% of @entity1 had a bicuspid aortic valve. The reimplantation technique was used in 72% and remodeling in 27% (1% other). No clinical advantage in terms of survival and reoperation of one technique over the other was found. Cusp repair was performed in 33%. Pooled early mortality was 2% (n  = 103). During follow-up (21,716 @entity1 -years), 262 @entity1 died (survival 92%), and 228 (5%) underwent reoperation, mainly valve replacement. Major adverse valve-related events were low (1.66% @entity1 -years). Preoperative severe @entity337 showed a trend toward higher reoperation rate. Remodeling and reimplantation techniques show comparable survival and valve durability results, providing a valid alternative to composite valve replacement. The heterogeneity in the data underlines the need  for a collaborative effort to standardize outcome reporting.
