{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:09:39Z","timestamp":1790352579572,"version":"4.1.0"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The optimal conduit choice for the Bentall procedure\u2014mechanical (MC) or biological (BC)\u2014is confounded by significant baseline selection bias. We aimed to evaluate the impact of conduit choice on early and long-term outcomes after mitigating this bias in a contemporary surgical cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed 442 consecutive patients undergoing elective Bentall procedures between 2015 and 2025 (365 MC vs 77 BC). Propensity score matching (1:1 nearest-neighbour, calliper 0.1) was performed based on 10 baseline covariates (including age, EuroSCORE II, and comorbidities) to generate a balanced cohort of 154 patients (77 per group). Operative outcomes, 30-day morbidity\/mortality, long-term overall survival (OS), and reoperation-free survival (RFS) were compared using paired statistical tests and Kaplan-Meier (log-rank) analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Propensity score matching successfully balanced baseline covariates, eliminating significant differences in age (mean 64.1 [MC] vs 65.7 [BC] years, P\u2009=\u2009.403) and EuroSCORE II (P\u2009=\u2009.698). The median follow-up was 36.0 months (interquartile range [IQR]: 18.0-78.0). In the propensity-matched cohort, no significant differences were found in long-term OS (P\u2009=\u2009.574) or RFS (P\u2009=\u2009.944) between the mechanical and biological groups. Early mortality was also comparable (P\u2009=\u2009.344). However, the biological group demonstrated a significantly higher rate of early re-exploration for bleeding (24.7% vs 6.5%, P\u2009=\u2009.003), associated with a 3.8-fold increased risk (odds ratio [OR]: 4.72, 95% confidence interval (CI), 1.66-13.40).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this 10-year propensity-matched analysis, both mechanical and bioprosthetic conduits demonstrated comparable long-term durability and survival outcomes. Although biological conduits were associated with a higher risk of early re-exploration for bleeding, this did not adversely affect early mortality or long-term RFS. These findings suggest that bioprosthetic conduits offer robust mid-term effectiveness, provided that meticulous intraoperative haemostasis is ensured to mitigate early bleeding risks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical registration number<\/jats:title>\n                    <jats:p>Not applicable (retrospective study).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/icvts\/ivag125","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T11:28:28Z","timestamp":1776770908000},"source":"Crossref","is-referenced-by-count":1,"title":["Mechanical Versus Bioprosthetic Conduits for the Bentall Procedure: A 10-Year Propensity Score-matched Analysis of Early and Long-Term Outcomes"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2323-9615","authenticated-orcid":false,"given":"Emine Aleyna","family":"Eroglu Polat","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Hospital , Istanbul, 34303,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gokay","family":"Altayl\u0131","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Hospital , Istanbul, 34303,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Okan","family":"Donbaloglu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Hospital , Istanbul, 34303,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mucahit","family":"Polat","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Hospital , Istanbul, 34303,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"2026051503420825800_ivag125-B1","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1136\/thx.23.4.338","article-title":"A technique for complete replacement of the ascending aorta","volume":"23","author":"Bentall","year":"1968","journal-title":"Thorax"},{"key":"2026051503420825800_ivag125-B2","doi-asserted-by":"publisher","first-page":"ezaf276","DOI":"10.1093\/ejcts\/ezaf276","article-title":"2025 ESC\/EACTS guidelines for the management of valvular heart disease","volume":"67","author":"Praz","year":"2025","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026051503420825800_ivag125-B3","doi-asserted-by":"publisher","first-page":"7158","DOI":"10.3390\/jcm14207158","article-title":"Valve-in-valve transcatheter aortic valve implantation versus redo SAVR for degenerated biological prosthesis: a narrative review stating our experience","volume":"14","author":"Torre","year":"2025","journal-title":"J Clin Med"},{"key":"2026051503420825800_ivag125-B4","doi-asserted-by":"publisher","first-page":"2717","DOI":"10.1016\/j.jacc.2021.02.038","article-title":"Valve Academic Research Consortium 3: updated endpoint definitions for aortic valve clinical research","volume":"77","author":"G\u00e9n\u00e9reux","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2026051503420825800_ivag125-B5","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1053\/j.optechstcvs.2018.12.002","article-title":"The button Bentall technique","volume":"23","author":"Kouchoukos","year":"2018","journal-title":"Oper Tech Thorac Cardiovasc Surg"},{"key":"2026051503420825800_ivag125-B6","doi-asserted-by":"publisher","first-page":"5105","DOI":"10.3390\/jcm14145105","article-title":"Mechanical versus biological Bentall procedure: a propensity-score matching analysis of 548 consecutive patients","volume":"14","author":"Galeone","year":"2025","journal-title":"J Clin Med"},{"key":"2026051503420825800_ivag125-B7","doi-asserted-by":"publisher","first-page":"242","DOI":"10.5090\/jcs.23.143","article-title":"Mechanical versus bioprosthetic aortic valve replacement in patients aged 50 to 70 years","volume":"57","author":"Song","year":"2024","journal-title":"J Chest Surg"},{"key":"2026051503420825800_ivag125-B8","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1093\/icvts\/ivab045","article-title":"Bentall procedure with the CarboSeal and CarboSeal Valsalva composite conduits: long-term outcomes","volume":"33","author":"Lechiancole","year":"2021","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2026051503420825800_ivag125-B9","doi-asserted-by":"publisher","first-page":"7414","DOI":"10.3390\/jcm12237414","article-title":"Platelet reduction after aortic bioprosthesis implantation: results from the PORTRAIT study","volume":"12","author":"Jiritano","year":"2023","journal-title":"J Clin Med"},{"key":"2026051503420825800_ivag125-B10","doi-asserted-by":"publisher","first-page":"e030328","DOI":"10.1161\/JAHA.123.030328","article-title":"Mechanical versus bioprosthetic aortic valve replacement in patients undergoing Bentall procedure","volume":"13","author":"Chen","year":"2024","journal-title":"J Am Heart Assoc"},{"key":"2026051503420825800_ivag125-B11","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1016\/j.athoracsur.2014.09.030","article-title":"Very long-term outcomes of the Carpentier-Edwards perimount valve in aortic position","volume":"99","author":"Bourguignon","year":"2015","journal-title":"Ann Thorac Surg"}],"container-title":["Interdisciplinary CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/icvts\/advance-article-pdf\/doi\/10.1093\/icvts\/ivag125\/68138293\/ivag125.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/41\/5\/ivag125\/68138293\/ivag125.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/41\/5\/ivag125\/68138293\/ivag125.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T07:42:11Z","timestamp":1778830931000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/article\/doi\/10.1093\/icvts\/ivag125\/8661075"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,22]]},"references-count":11,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5,5]]}},"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivag125","relation":{},"ISSN":["2753-670X"],"issn-type":[{"value":"2753-670X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5]]},"published":{"date-parts":[[2026,4,22]]},"article-number":"ivag125"}}