Article Abstract

Valve-sparing aortic root replacement—midterm outcomes and quality of life

Authors: Abdel-Kémal Bori Bata, Nicolas D’Ostrevy, Bruno Pereira, Etienne Geoffroy, Nicolas Dauphin, Vedat Eljezi, Kasra Azarnoush, Lucie Ulman, Lionel Camilleri


Background: This study evaluated the midterm outcomes, the valve related events and quality of life of patients treated by valve-sparing aortic root replacement (VSRR).
Methods: From January 2003 to December 2014, 88 con-secutive patients diagnosed with an aortic root aneurysm or ascending aortic aneurysms underwent VSRR surgery. The mean age was 55±14 (range 19–77) years. A total of 84% of the patients were male; 89% were in New York Heart Association functional class I or II, 55% had aortic regurgitation (AR) grade III or IV. Twenty-four patients (27.3%) had bicuspid aortic valve. The mean left ventricular ejection fraction (LVEF) was 61%±9% (range 29–78%). Patients were yearly followed by family doctors and referent cardi-ologists. Doppler echocardiographic examinations were obtained annually in all patients. The midterm clinical, echocardiographic results and quality of life were analyzed. The mean follow-up was 5.3±3 (range 1–12) years.
Results: Hospital mortality was 1%. There were ten late deaths (11%) including 5 cardiac cases. Two patients (2%) required an aortic valve or graft prosthesis reoperation. Aortic valve endocarditis occurred in two patients. Thromboembolic events were reported in 3 patients. None of the following morbidity has been observed: structural valve deterioration, nonstructural dysfunction, valve thrombosis, bleeding event. The 5- and 8-year survival were 92% and 88%, respectively. The 8-year survival free from cardiac death was 88%. The mean of EuroQoL visual analogue scale (EQ VAS) and EQ index were respectively 83±15 (range 30–100) and 0.94±0.12 (range 0.5–1).
Conclusions: Eight-year clinical improvement, function of the spared aortic valve and quality of life after valve sparing aortic root surgery appear excellent.