{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:14:11Z","timestamp":1787843651773,"version":"build-2784847793"},"reference-count":60,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2019,8,28]],"date-time":"2019-08-28T00:00:00Z","timestamp":1566950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"National Institute for Health Research Imperial College Biomedical Research Centre"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p\/><jats:p>In aortic root aneurysms, the challenge of a valve-sparing aortic root replacement (VSRR) procedure is to ensure durable aortic valve function without reintervention. Although the Bentall procedure defers the durability of valve function to the prosthesis, short- and long-term complications tend to be higher. The aim of this study was to compare the outcomes of VSRR and Bentall procedures in patients with aortic root aneurysms. A systematic literature review was conducted using PubMed regarding the outcomes of the Bentall procedure compared with those of VSRR from the inception of the 2 procedures until July 2018. Studies with short- and long-term comparative data were included. An initial search yielded 9517 titles. Thirty-four studies were finally included for meta-analysis (all retrospective, non-randomized), comprising 7313 patients (2944 valve-sparing and 4369 Bentall procedures) with no evidence of publication bias. Operative mortality was found to be significantly lower in the VSRR group [odds ratio (OR) 0.51, 95% confidence interval (CI) 0.37\u20130.70; P\u2009&lt;\u20090.001] despite overall higher cardiopulmonary bypass and aortic cross-clamp times. The 5-year survival rate was also more favourable in the VSRR group (OR 1.93 95% CI 1.15\u20133.23; P\u2009&lt;\u20090.05). Significantly lower rates of cerebral thromboembolism (OR 0.668, 95% CI 0.477\u20130.935; P\u2009=\u20090.019) and heart block (OR 0.386, 95% CI 0.195\u20130.767; P\u2009=\u20090.007) were also found after VSRR. There was no significant difference in rates of reoperation between the groups at long-term follow-up (OR 1.32, 95% CI 0.75\u20132.33; P\u2009=\u20090.336). Meta-regression of patient and operative covariates yielded no influence on the main outcomes (P\u2009&gt;\u20090.05). These findings suggest that VSRR is an appropriate and potentially better treatment option for a root aneurysm when the aortic valve is repairable.<\/jats:p>","DOI":"10.1093\/icvts\/ivz211","type":"journal-article","created":{"date-parts":[[2019,8,11]],"date-time":"2019-08-11T00:46:19Z","timestamp":1565484379000},"page":"911-922","source":"Crossref","is-referenced-by-count":25,"title":["Comparing outcomes between valve-sparing root replacement and the Bentall procedure in proximal aortic aneurysms: systematic review and meta-analysis"],"prefix":"10.1093","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4085-1294","authenticated-orcid":false,"given":"Mohammad Yousuf","family":"Salmasi","sequence":"first","affiliation":[{"name":"Department of Surgery and Cancer, Imperial College, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iakovos","family":"Theodoulou","sequence":"additional","affiliation":[{"name":"Faculty of Life Sciences and Medicine, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6880-4230","authenticated-orcid":false,"given":"Priyanka","family":"Iyer","sequence":"additional","affiliation":[{"name":"Faculty of Life Sciences and Medicine, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3429-1400","authenticated-orcid":false,"given":"Mohaimen","family":"Al-Zubaidy","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0599-4951","authenticated-orcid":false,"given":"Danial","family":"Naqvi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2200-9025","authenticated-orcid":false,"given":"Mohammed","family":"Snober","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aung","family":"Oo","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Barts Heart Centre, St. Bartholomew's Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanos","family":"Athanasiou","sequence":"additional","affiliation":[{"name":"Faculty of Life Sciences and Medicine, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,8,28]]},"reference":[{"key":"2019112510404647300_ivz211-B1","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.ijcard.2005.11.043","article-title":"Echocardiographic anatomy of ascending aorta dilatation: correlations with aortic valve morphology and function","volume":"113","author":"Della Corte","year":"2006","journal-title":"Int J Cardiol"},{"key":"2019112510404647300_ivz211-B2","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1093\/eurjhf\/hfs105","article-title":"ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the task force for the diagnosis and treatment of acute and chronic heart failure 2012 of the European Society of Cardiology. 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