Root Remodeling versus Root Reimplantation in Patients with Bicuspid Aortic Valve and Root Aneurysm Article Swipe
Fei Xiang
,
Lin Chen
,
Eric E. Roselli
,
Brian P. Griffin
,
Milind Y. Desai
,
Jeevanantham Rajeswaran
,
Austin Firth
,
Eugene H. Blackstone
,
Lars G. Svensson
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1055/s-0045-1809688
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1055/s-0045-1809688
Valve-sparing root replacements are increasingly being performed in patients with bicuspid aortic valve (BAV) and root aneurysm. This study aims to compare the outcomes of patients who underwent root remodeling versus root reimplantation. From 2000 to 2022, 206 adults with BAV and root aneurysm (mean age: 47 ± 12 years, 183 [89%] male) underwent root remodeling (n = 32) or reimplantation (n = 174) at Cleveland Clinic. Compared with remodeling, patients in the reimplantation group had more aortic regurgitation (severe 61/174 [35%] vs. 3/32 [9.4%]) and smaller aortic roots (sinus diameter: 4.3 ± 0.56 vs. 4.6 ± 0.47 cm). Operative mortality and morbidity, durability, and time-related mortality were compared. Patients in both groups underwent additional aortic valve repair (reimplantation vs. remodeling group: figure-of-8 hitch-up stitch 10/174 [5.7%] vs. 14/32 [44%], p < 0.001; cusp plication 91/174 [52%] vs. 11/32 [34%], p = 0.06). Compared with the remodeling group, aortic clamp time was longer in the reimplantation group (median 136 vs. 76 minutes, p < 0.001). Two in-hospital reoperations occurred after remodeling from valve dysfunction. One operative death occurred in each group. At 5 years, severe aortic regurgitation was 16% after remodeling versus 5.0% after reimplantation (p = 0.06), mean gradient 11 versus 10 mm Hg (p = 0.12), aortic valve reoperation 23% versus 6.0% (p = 0.14), and survival 97% versus 95%, respectively (p = 0.71). Both root remodeling and reimplantation can be safely performed in patients with BAV and root aneurysms with similar midterm outcomes. Although root remodeling is a shorter surgery, less late aortic valve regurgitation and fewer valve reoperations lead us to recommend root reimplantation.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1055/s-0045-1809688
- http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0045-1809688.pdf
- OA Status
- hybrid
- References
- 13
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4411227435
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4411227435Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1055/s-0045-1809688Digital Object Identifier
- Title
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Root Remodeling versus Root Reimplantation in Patients with Bicuspid Aortic Valve and Root AneurysmWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2025Year of publication
- Publication date
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2025-02-01Full publication date if available
- Authors
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Fei Xiang, Lin Chen, Eric E. Roselli, Brian P. Griffin, Milind Y. Desai, Jeevanantham Rajeswaran, Austin Firth, Eugene H. Blackstone, Lars G. SvenssonList of authors in order
- Landing page
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https://doi.org/10.1055/s-0045-1809688Publisher landing page
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https://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0045-1809688.pdfDirect link to full text PDF
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YesWhether a free full text is available
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hybridOpen access status per OpenAlex
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https://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0045-1809688.pdfDirect OA link when available
- Concepts
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Aortic root, Bicuspid aortic valve, Medicine, Cardiology, Replantation, Root (linguistics), Internal medicine, Aortic valve, Surgery, Aorta, Linguistics, PhilosophyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
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13Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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