{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T08:01:25Z","timestamp":1779177685447,"version":"3.51.4"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,12,17]],"date-time":"2020-12-17T00:00:00Z","timestamp":1608163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>\u2002<\/jats:title>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>Our goal was to analyse the influence of preoperative aortic regurgitation (AR) on the necessity of cusp repair during valve-sparing reimplantation (VSR). We focused on patients with tricuspid aortic valves (TAV) and evaluated the impact of AR and cusp repair on long-term outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>From March 1998 to December 2018, a total of 512 consecutive patients underwent VSR at our institution; of these, 303 had a TAV. The mean age was 53\u2009\u00b1\u200915\u2009years, and the median follow-up was 6.12\u2009years. The rate and type of cusp repair were analysed based on preoperative AR. Time-to-event analysis was performed, as well as risk of death, reoperation and AR recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Cusp repair was necessary in 168 (55.4%) patients; the rate rose significantly as AR grade increased (P\u2009&amp;lt;\u20090.001). In-hospital mortality was 1% (n\u2009=\u20093). At 5 and 10\u2009years, overall survival was 92\u2009\u00b1\u20092% and 75\u2009\u00b1\u20095%, respectively. Freedom from valve reoperation was 95\u2009\u00b1\u20092% and 90\u2009\u00b1\u20093%. Freedom from AR &amp;gt;2+ and AR &amp;gt;1+ at 10\u2009years was 88\u2009\u00b1\u20094% and 70.4\u2009\u00b1\u20094.6%, respectively. Independent predictors of death included age, New York Heart Association functional class and type-A aortic dissection. Predictors of AR greater than mild included previous cardiac surgery and severe preoperative AR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>In patients with TAV receiving VSR, the necessity of cusp repair increased with the degree of preoperative AR. Preoperative AR and cusp repair do not impact long-term survival and aortic valve reoperation, but severe preoperative AR and multiple cusp repair increase the risk of recurrent moderate-to-severe AR. Overall, cusp repair seems to attenuate the negative impact of preoperative AR for at least 1 decade in a majority of patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaa427","type":"journal-article","created":{"date-parts":[[2020,11,3]],"date-time":"2020-11-03T07:08:42Z","timestamp":1604387322000},"page":"1069-1076","source":"Crossref","is-referenced-by-count":35,"title":["Two decades of valve-sparing root reimplantation in tricuspid aortic valve: impact of aortic regurgitation and cusp repair"],"prefix":"10.1093","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8256-3656","authenticated-orcid":false,"given":"Saadallah","family":"Tamer","sequence":"first","affiliation":[{"name":"Cardiovascular and Thoracic Surgery Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9976-4120","authenticated-orcid":false,"given":"Stefano","family":"Mastrobuoni","sequence":"additional","affiliation":[{"name":"Cardiovascular and Thoracic Surgery Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillaume","family":"Lemaire","sequence":"additional","affiliation":[{"name":"Anesthesiology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9963-9490","authenticated-orcid":false,"given":"Jama","family":"Jahanyar","sequence":"additional","affiliation":[{"name":"Cardiovascular and Thoracic Surgery Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emiliano","family":"Navarra","sequence":"additional","affiliation":[{"name":"Cardiovascular and Thoracic Surgery Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3220-2681","authenticated-orcid":false,"given":"Alain","family":"Poncelet","sequence":"additional","affiliation":[{"name":"Cardiovascular and Thoracic Surgery Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parla","family":"Astarci","sequence":"additional","affiliation":[{"name":"Cardiovascular and Thoracic Surgery Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gebrine","family":"El Khoury","sequence":"additional","affiliation":[{"name":"Cardiovascular and Thoracic Surgery 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