{"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":1791390499738,"version":"4.3.3"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,10,29]],"date-time":"2022-10-29T00:00:00Z","timestamp":1667001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p\/><jats:sec><jats:title>OBJECTIVES<\/jats:title><jats:p>Our goal was to evaluate the outcome of valve-sparing root replacement (VSRR) and to compare the outcomes to those of patients having composite valve\u2013graft conduit aortic root replacement (CVG-ARR) in a cohort of patients with aortic root aneurysm \u00b1 valve insufficiency, without valvular stenosis. Although valve-sparing procedures are preferable in young patients, there is a lack of comparative data in comparable patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The VSRR procedures were performed in 2005 patients, and 218 patients underwent a CVG-ARR procedure. Exclusion criteria included aortic dissection, endocarditis and valvular stenosis. Propensity score matching (3:1 ratio) was applied to compare VSRR (reimplantation 33% and remodelling 67%) and CVG-ARR.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>We matched 218 patients with CVG-ARR to 654 patients with VSRR (median age, 56.0; median follow-up was 4\u2009years in both groups; interquartile range 1\u20135\u2009years). Early mortality was 1.1% of those who had VSRR versus 2.3% in those who had CVG-ARR. Survival was 95.4% [95% confidence interval (CI) 94\u201397%] at 5\u2009years in patients who had VSRR versus 85.4% (95% CI 82\u201392%) in those who had CVG-ARR; P\u2009=\u20090.002. Freedom from reintervention at 5\u2009years was 96.8% (95% CI 95\u201398%) with VSRR and 95.4% (95% CI 91\u201399%) with CVG-ARR (P\u2009=\u20090.98). Additionally, there were more thromboembolic, endocarditis and bleeding events in the patients who had CVG-ARR (P\u2009=\u20090.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>This multicentre study shows excellent results after valve-sparing root replacement in patients with an ascending aortic aneurysm with or without valve insufficiency. Compared to composite valve-graft aortic root replacement, survival is better and valve-related events are fewer. Consequently, valve-sparing procedures should be considered whenever a durable repair is feasible. We advocate a valve-sparing strategy even in more complex cases when performed in experienced centres.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ejcts\/ezac514","type":"journal-article","created":{"date-parts":[[2022,10,29]],"date-time":"2022-10-29T13:47:48Z","timestamp":1667051268000},"source":"Crossref","is-referenced-by-count":33,"title":["A multicentre, propensity score matched analysis comparing a valve-sparing approach to valve replacement in aortic root aneurysm: Insight from the AVIATOR database"],"prefix":"10.1093","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3754-8558","authenticated-orcid":false,"given":"Bardia","family":"Arabkhani","sequence":"first","affiliation":[{"name":"Leiden University Medical Center (LUMC) , Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6507-3855","authenticated-orcid":false,"given":"Robert J 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Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2391-568X","authenticated-orcid":false,"given":"Emmanuel","family":"Lansac","sequence":"additional","affiliation":[{"name":"Institut Mutualiste Montsouris , Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0251-9100","authenticated-orcid":false,"given":"Hans-Joachim","family":"Sch\u00e4fers","sequence":"additional","affiliation":[{"name":"Homburg-Saarland University Medical Center , Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismail","family":"El-Hamamsy","sequence":"additional","affiliation":[{"name":"Montr\u00e9al Heart Institute , Montr\u00e9al, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marien","family":"Lenoir","sequence":"additional","affiliation":[{"name":"Montr\u00e9al Heart Institute , Montr\u00e9al, Quebec, 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Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5942-4727","authenticated-orcid":false,"given":"Jolanda","family":"Kluin","sequence":"additional","affiliation":[{"name":"Amsterdam UMC , Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dave R","family":"Koolbergen","sequence":"additional","affiliation":[{"name":"Amsterdam UMC , Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4127-7327","authenticated-orcid":false,"given":"Olivier","family":"Bouchot","sequence":"additional","affiliation":[{"name":"CHU le Bocage , Dijon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Rudez","sequence":"additional","affiliation":[{"name":"University Hospital Dubrava , Zagreb, 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