{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:28:19Z","timestamp":1791390499709,"version":"4.3.3"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T00:00:00Z","timestamp":1650326400000},"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":[[2022,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>We investigated whether aortic valve fenestrations (respected or fixed) represent a factor associated with recurrent aortic insufficiency or reoperation after repair.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Between 2003 and 2019, patients who underwent aortic valve repair were included. Aortic insufficiency phenotypes were root aneurysm (repair: root remodelling + annuloplasty), ascending aorta aneurysm (repair: tubular aortic replacement + annuloplasty) and isolated regurgitation (repair: single\/double annuloplasty). Fenestrations were either respected or fixed according to their features.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A total of 618 patients (out of 798 operated on; 77.4%) had their valve repaired, with 167 cases of fenestrations (128 were respected, 39 fixed\u201432 with a patch, 6 with running suture and 1 with both). After conducting propensity score matching between no-fenestration (n\u2009=\u2009167) and fenestration groups (n\u2009=\u2009167), respectively, we noted the following: survival [90.3% (n\u2009=\u20097 deaths) vs 95.8% (n\u2009=\u20094)], cumulative incidence of reoperation [6.7% (n\u2009=\u20097) vs 5.2% (n\u2009=\u20094)], aortic insufficiency grade \u2265 3 [6.4% (n\u2009=\u20096) vs 4.4% (n\u2009=\u20094)] and grade \u2265 2 [28.9% (n\u2009=\u200928) vs 37.1% (n\u2009=\u200935)] were similar at 9\u2009years [P\u2009=\u20090.94; median follow-up: 2.2, interquartile range: (0.8, 5.8)], whether fenestration was respected (P\u2009=\u20090.55) or fixed (P\u2009=\u20090.6, at 6\u2009years). Standardization of the surgical approach (consisting of double annuloplasty in isolated regurgitation phenotype and expansible subvalvular annuloplasty with effective height assessment with remodelling repair for root aneurysm phenotype) reduced the risk of reoperation (era before standardization: hazard ratio: 5.4, 95% confidence interval: 1.9\u201315.7, P\u2009=\u20090.002).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Fenestration, respected or fixed, is not a factor associated with reoperation or recurrence of significant aortic insufficiency after valve repair if the surgical approach is standardized.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezac263","type":"journal-article","created":{"date-parts":[[2022,4,15]],"date-time":"2022-04-15T03:58:33Z","timestamp":1649995113000},"source":"Crossref","is-referenced-by-count":6,"title":["Aortic valve fenestration: respect it or fix it?"],"prefix":"10.1093","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5405-4755","authenticated-orcid":false,"given":"Nathanael","family":"Shraer","sequence":"first","affiliation":[{"name":"Department of Cardiac Pathology, Institut Mutualiste Montsouris , Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pouya","family":"Youssefi","sequence":"additional","affiliation":[{"name":"Royal Brompton & Harefield NHS Trust , London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Luc","family":"Monin","sequence":"additional","affiliation":[{"name":"Department of Cardiac Pathology, Institut Mutualiste Montsouris , Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Berrebi","sequence":"additional","affiliation":[{"name":"Department of Cardiac Pathology, Institut Mutualiste Montsouris , Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Mankoubi","sequence":"additional","affiliation":[{"name":"Department of Cardiac Pathology, Institut Mutualiste Montsouris , Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Noghin","sequence":"additional","affiliation":[{"name":"Department of Cardiac Pathology, Institut Mutualiste Montsouris , Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Debauchez","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, Piti\u00e9-Salp\u00eatri\u00e8re APHP Hospital , Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Lansac","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, Piti\u00e9-Salp\u00eatri\u00e8re APHP Hospital , Paris, 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