Vol. 28 No. 4 (2024)
ACQUIRED HEART DISEASES

Does aortic valve anatomy affect the long-term outcomes of aortic root reimplantation? A retrospective study with propensity score matching

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  • A.V. Kokorin,
  •  V.V. Aminov,
  • O.P. Lukin,
  • A.V. Bogachev-Prokofiev
A.V. Kokorin
Federal Centre of Cardiovascular Surgery, Ministry of Health of Russian Federation, Chelyabinsk
Bio
 V.V. Aminov
Federal Centre of Cardiovascular Surgery, Ministry of Health of Russian Federation, Chelyabinsk
O.P. Lukin
Federal Centre of Cardiovascular Surgery, Ministry of Health of Russian Federation, Chelyabinsk
A.V. Bogachev-Prokofiev
Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk
Central illustration
DOI: https://doi.org/10.21688/1681-3472-2024-4-33-45

Published 2024-12-27

Keywords

  • Aortic Valve,
  • Aortic Valve Insufficiency,
  • Bicuspid Aortic Valve Disease,
  • Follow-Up Studies,
  • Propensity Score,
  • Reimplantation,
  • Retrospective Studies
    • ...More
    Less

How to Cite

Kokorin, . A., Aminov,  V.V., Lukin, . O., & Bogachev-Prokofiev, . A. (2024). Does aortic valve anatomy affect the long-term outcomes of aortic root reimplantation? A retrospective study with propensity score matching. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 28(4), 33–45. https://doi.org/10.21688/1681-3472-2024-4-33-45

Copyright (c) 2024 Kokorin A.V., Aminov V.V., Lukin O.P., Bogachev-Prokofiev A.V.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Introduction: The results of aortic root reimplantation techniques in patients with tricuspid aortic valve (TAV) are generally recognized. However, data on the results of valve-preserving operations in patients with bicuspid aortic valve (BAV) remain limited.
Objective: In this retrospective study we compare the long-term results of reimplantation technique, depending on the type of aortic valve (AV): BAV versus TAV.
Methods: The retrospective study included 224 patients (average age 48.43 ± 13.70 years, 81.2% men) who underwent valve-preserving operations by reimplantation of the aortic root from January 2013 to January 2023. Depending on the anatomical variant of the AV, the entire sample was divided into two groups: 76 patients with BAV (33.9%) and 148 patients with TAV (66.1%). To eliminate the systematic differences between the compared groups, the propensity score matching (PSM) analysis was used in order to compare groups by 12 criteria. As a result, 33 pairs of patients were formed. After the PSM analysis, there were no significant differences between the groups.
Results: In total, 221 (98.2%) patients were examined in the long-term period. The average follow-up period for the entire sample was 53.17 ± 26.34 months. After the PSM analysis, there were no significant differences between the groups in the number of patients examined, namely 33 individuals (100%) in each group. The average follow-up period was 55.24 ± 22.66 months. At long-term follow-up, 100% survival was recorded in both groups. Prior to the PSM analysis, the freedom from aortic insufficiency (AI) grade ≥ II in the patients with TAV was 90.2% and 88.2% at 5 and 10 year follow-up periods, and in patients with BAV this indicator was 89.6% and 89.6% (p = 0.786), respectively. After the PSM analysis, the freedom from AI grade ≥ II in the patients with TAV was 84.2% and 84.2% at 5 and 8 year follow-up periods, and in the group with BAV it was 85.1% and 85.1% (p = 1.000), respectively. Prior to the PSM analysis, freedom from aortic valve reoperation at 5 and 10 year follow-up periods in the patients with TAV was 99.3%, and in the patients with BAV it was 98.6% (p = 1.000). After the PSM analysis, this indicator at 5 and 8 year follow-up periods in the patients with TAV and with BAV was 100% and 96.7%, respectively (p = 1.000).
Conclusion: The reimplantation technique enables to effectively reconstruct the aortic root regardless of the anatomical variant of the AV, providing excellent survival with a low risk of reoperation.

Received 2 October 2024. Revised 4 November 2024. Accepted 8 November 2024.

Funding
The research was carried out within the framework of the grant of the Russian Science Foundation No. 23-15-00434.

Conflict of interest
The authors declare no conflict of interest.

Contribution of the authors
The authors contributed equally to this article.

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