PMID- 34465542 OWN - NLM STAT- MEDLINE DCOM- 20211213 LR - 20211214 IS - 1444-2892 (Electronic) IS - 1443-9506 (Linking) VI - 31 IP - 1 DP - 2022 Jan TI - Fifteen-Year Outcomes Following Valve-Sparing Aortic Root Replacement in Elderly Patients. PG - 144-152 LID - S1443-9506(21)01160-4 [pii] LID - 10.1016/j.hlc.2021.07.013 [doi] AB - BACKGROUND: Valve-sparing aortic root replacement (VSRR) techniques have several advantages such as preservation of physiological haemodynamics of the native aortic valve and avoidance of prosthetic valve-related complications. However, VSRR procedures are generally performed in young patients and the long-term results in elderly patients (>/=65 years) are scarce. METHODS: Fifty-six (56) consecutive patients underwent VSRR surgery by a single surgeon at the current centre between January 2006 and December 2013; a modified "remodelling technique" was typically performed. The mean age was 58.86+/-12.5 years; Marfan syndrome and bicuspid aortic valve were both present in six patients (10.7%); 38 patients (67.8%) presented with greater than moderate aortic regurgitation; and 17 patients (30.4%) were in New York Heart Association (NYHA) class III before surgery. They were divided into two groups according to their ages receiving VSRR surgery: Group E (elderly patients aged >/=65 years, n=24) and Group Y (young patients aged <65 years, n=32). The primary outcomes were aortic valve-related reoperation, cardiovascular reoperation, all-cause mortality, and functional status. RESULTS: One (1) patient in Group E was converted to aortic valve replacement as a result of a failed aortic valve repair. No perioperative mortality was observed. The mean follow-up was 11.5+/-2.9 years. Aortic valve-related reoperation was noted in two patients of each group (one with endocarditis, one with severe aortic regurgitation). Cardiovascular reoperations were observed in three and six patients, and all-cause deaths in seven and two patients in Group E and Group Y, respectively. The 10-year freedom from aortic valve-related reoperation was estimated to be 91.7+/-5.6% and 92.7+/-5.0% (p=0.594), the 10-year freedom from cardiovascular reoperation was 86.4+/-7.3% and 81.1+/-7.7% (p=0.781), and the cumulative 10-year survival rates were 74.0+/-9.2% and 93.8+/-4.3% (p=0.018) in Group E and Group Y, respectively. During follow-up, 6.7% of patients were in NYHA class III and 6.4% of patients developed moderate-to-severe aortic regurgitation. Cox regression analysis failed to identify predictors for primary outcomes. CONCLUSION: Valve-sparing aortic root replacement can safely be performed in elderly patients with low early mortality and satisfactory long-term freedom from aortic valve-related and cardiovascular re-intervention. CI - Copyright (c) 2021. Published by Elsevier B.V. FAU - Liu, Yihua AU - Liu Y AD - Department of Cardiovascular Surgery and Heart Transplantation, University Hospital of Nancy-Brabois, Vandoeuvre-les-Nancy, France; Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. FAU - Benzha, Mohamed-Yassine AU - Benzha MY AD - Department of Cardiovascular Surgery and Heart Transplantation, University Hospital of Nancy-Brabois, Vandoeuvre-les-Nancy, France. FAU - Hubert, Maxime AU - Hubert M AD - Department of Cardiovascular Surgery and Heart Transplantation, University Hospital of Nancy-Brabois, Vandoeuvre-les-Nancy, France. FAU - Perin, Benjamin AU - Perin B AD - Department of Cardiovascular Surgery and Heart Transplantation, University Hospital of Nancy-Brabois, Vandoeuvre-les-Nancy, France. FAU - Lauria, Giuseppe AU - Lauria G AD - Department of Cardiovascular Surgery and Heart Transplantation, University Hospital of Nancy-Brabois, Vandoeuvre-les-Nancy, France. FAU - Dan, Pan AU - Dan P AD - Department of Cardiovascular Surgery and Heart Transplantation, University Hospital of Nancy-Brabois, Vandoeuvre-les-Nancy, France. FAU - Phamisith, Elodie AU - Phamisith E AD - Department of Cardiovascular Surgery and Heart Transplantation, University Hospital of Nancy-Brabois, Vandoeuvre-les-Nancy, France. FAU - Scadi, Soukaina AU - Scadi S AD - Department of Cardiology, University Hospital of Nancy-Brabois, Vandoeuvre-les-Nancy, France. FAU - Dong, Nianguo AU - Dong N AD - Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. FAU - Villemot, Jean-Pierre AU - Villemot JP AD - Department of Cardiovascular Surgery and Heart Transplantation, University Hospital of Nancy-Brabois, Vandoeuvre-les-Nancy, France. FAU - Maureira, Juan-Pablo AU - Maureira JP AD - Department of Cardiovascular Surgery and Heart Transplantation, University Hospital of Nancy-Brabois, Vandoeuvre-les-Nancy, France. Electronic address: Pablomaureira@hotmail.com. LA - eng PT - Journal Article DEP - 20210828 PL - Australia TA - Heart Lung Circ JT - Heart, lung & circulation JID - 100963739 SB - IM MH - Aged MH - Aorta/surgery MH - Aortic Valve/surgery MH - *Aortic Valve Insufficiency/surgery MH - *Heart Valve Prosthesis Implantation MH - Humans MH - *Marfan Syndrome/surgery MH - Middle Aged MH - Reoperation MH - Retrospective Studies MH - Treatment Outcome OTO - NOTNLM OT - Aortic regurgitation OT - Aortic root aneurysm OT - Valve sparing aortic root replacement EDAT- 2021/09/02 06:00 MHDA- 2021/12/15 06:00 CRDT- 2021/09/01 05:54 PHST- 2021/03/19 00:00 [received] PHST- 2021/07/10 00:00 [revised] PHST- 2021/07/18 00:00 [accepted] PHST- 2021/09/02 06:00 [pubmed] PHST- 2021/12/15 06:00 [medline] PHST- 2021/09/01 05:54 [entrez] AID - S1443-9506(21)01160-4 [pii] AID - 10.1016/j.hlc.2021.07.013 [doi] PST - ppublish SO - Heart Lung Circ. 2022 Jan;31(1):144-152. doi: 10.1016/j.hlc.2021.07.013. Epub 2021 Aug 28.