The following is a summary of “Long-term outcomes of valve-sparing aortic root versus composite aortic valve graft replacement for aortic root aneurysm: Meta-analysis of reconstructed time-to-event data,” published in the SEPTEMBER 2023 issue of Surgery by Sá, et al.
For a study, researchers sought to assess the long-term outcomes of valve-sparing aortic root replacement (VSARR) compared to composite aortic valve graft replacement (CAVGR) for treating aortic root aneurysms. A meta-analysis used Kaplan–Meier-derived time-to-event data from studies with follow-up data, including propensity-score matching or adjustment.
The analysis included six studies with 3,215 patients, of which 1,770 were treated with VSARR and 1,445 with CAVGR. The results indicated a statistically significant difference in overall survival, favoring VSARR (Hazard Ratio [HR] 0.63, 95% CI 0.49–0.82, P = 0.001). However, there was no statistically significant difference in the risk of reoperation (HR 0.77, 95% CI 0.51–1.14, P = 0.187) over the entire follow-up period. Further analysis, focusing on the first 10 years after the procedure, revealed comparable reoperation rates between VSARR and CAVGR (HR 0.96, 95% CI 0.62–1.48, P = 0.861). However, results beyond the 10-year mark showed improved rates of freedom from reoperation in patients who underwent VSARR (HR 0.10, 95% CI 0.01–0.78; P = 0.027).
In the long-term follow-up of patients treated for aortic root aneurysms, VSARR appeared to offer better overall survival and a lower risk of reoperation compared to CAVGR.