{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T11:00:29Z","timestamp":1784977229286,"version":"3.55.0"},"reference-count":67,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["UIDB\/00051\/2020 and UIDP\/00051\/2020"],"award-info":[{"award-number":["UIDB\/00051\/2020 and UIDP\/00051\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Innovations&amp;#65533;(Phila)"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The progressive dissemination of isolated aortic valve repair (AVRep) and valve-sparing root (VSR) procedures has resulted in a cumulative expansion of the available literature. This work aims to synthesize the current knowledge and identify predictors of mortality and reintervention in patients undergoing such valve-preserving procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A systematic review and meta-analysis were conducted in 2 databases (last search January 2025). Studies with \u2265200 adult patients undergoing AVRep or VSR with a minimum mean follow-up \u22655 years were included. Short-term outcomes were summarized using weighted descriptive statistics. Forest plots, funnel plots, and the Newcastle\u2013Ottawa Scale were used to evaluate the risk of bias. Long-term survival and freedom from reoperation were analyzed through reconstructing individual patient data from Kaplan\u2013Meier curves, and a mixed-effects Cox frailty model was used to identify study-level predictors of these endpoints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were 48 studies included, encompassing 20,914 patients with a mean weighted age of 52.42 (50.28 to 54.57) years. Early outcomes included hospital mortality (1.34% [1.04% to 1.73%]), bleeding (3.77% [2.76% to 5.13%]), myocardial ischemia (0.44% [0.26% to 0.77%]), pacemaker implantation (1.00% [0.63% to 1.59%]), neurologic events (1.27% [0.91% to 1.78%]), and postoperative residual aortic regurgitation (3.48% [1.90% to 6.29%]). Pooled survival at 1, 5, 10, and 20 years of follow-up was 96.8%, 92.5%, 83.8%, and 67%, respectively; freedom from reoperation at the same time points was 97.9%, 93.9%, 88.2%, and 77.5%, respectively. Factors such as older age, female sex, aortic dissection, and isolated valve repair were associated with higher mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>These findings suggest that AVRep and VSR are associated with low early mortality and morbidity and excellent long-term outcomes. However, heterogeneity in definitions and endpoints across studies underlines the need for standardized definitions and conduction of properly designed randomized trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15569845261438464","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T04:59:46Z","timestamp":1778561986000},"page":"111-121","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of Aortic Valve Repair: A Systematic Review and Meta-Analysis Using Reconstructed Individual Patient Data"],"prefix":"10.1177","volume":"21","author":[{"given":"Rui J.","family":"Cerqueira","sequence":"first","affiliation":[{"name":"UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Portugal"},{"name":"Cardiothoracic Surgery Department, Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3401-1513","authenticated-orcid":false,"given":"Jo\u00e3o Q.","family":"Mascarenhas","sequence":"additional","affiliation":[{"name":"UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joana O.","family":"Miranda","sequence":"additional","affiliation":[{"name":"UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal J.","family":"Kawczynski","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Maastricht University Medical Center+, The Netherlands"},{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Vojacek","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Hradec Kralove, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bardia","family":"Arabkhani","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elham","family":"Bidar","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Maastricht University Medical Center+, The Netherlands"},{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelino","family":"Leite-Moreira","sequence":"additional","affiliation":[{"name":"UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Portugal"},{"name":"Cardiothoracic Surgery Department, Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisca","family":"Saraiva","sequence":"additional","affiliation":[{"name":"UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Heuts","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Maastricht University Medical Center+, The Netherlands"},{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20.1.3"},{"key":"e_1_3_2_3_2","first-page":"1305","article-title":"Treatment of aortic insufficiency by means of aortic annuloplasty [in French]","volume":"59","author":"Cabrol C","year":"1966","unstructured":"Cabrol C, Cabrol A, Guiraudon G, et al. Treatment of aortic insufficiency by means of aortic annuloplasty [in French]. Arch Mal Coeur Vaiss 1966; 59: 1305\u20131312.","journal-title":"Arch Mal Coeur Vaiss"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8191.1988.tb00214.x"},{"key":"e_1_3_2_5_2","first-page":"383","article-title":"Subvalvular circular annuloplasty as a component of aortic valve repair","volume":"11","author":"Izumoto H","year":"2002","unstructured":"Izumoto H, Kawazoe K, Kawase T, et al. Subvalvular circular annuloplasty as a component of aortic valve repair. J Heart Valve Dis 2002; 11: 383\u2013385.","journal-title":"J Heart Valve Dis"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2015.07.068"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)34942-6"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)34225-4"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2003.10.103"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2016.10.081"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(98)70408-8"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.21037\/acs.2019.04.16"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2019.09.016"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.08.054"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-135"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-12-9"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.21037\/acs-2023-avs1-23"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.21037\/acs-2023-avs1-21"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2014.04.048"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12055-019-00842-x"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.03.105"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezad137"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2013.08.015"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2023.06.002"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezac366"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2018.09.129"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivz324"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2023.04.033"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivac058"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezab136"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2019.07.025"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2020.09.070"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2022.04.058"},{"key":"e_1_3_2_34_2","first-page":"35","article-title":"AORTLANTIC: French registry of aortic valve-sparing root replacement, preliminary multicentre results from western France","author":"Dubost C","year":"2022","unstructured":"Dubost C, Tomasi J, Ducroix A, et al. AORTLANTIC: French registry of aortic valve-sparing root replacement, preliminary multicentre results from western France. Interact Cardiovasc Thorac Surg 2022; 35.","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2022.01.061"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.21037\/acs-2021-bav-208"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2019.10.020"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2017.09.019"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2023.08.055"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2018.10.075"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2017.12.039"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2006.03.053"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.09.013"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.11.036"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-872961"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezac104"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2020.07.121"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2011.07.036"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2023.11.027"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/4076881"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2016.09.055"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2020.10.159"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezaa471"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2009.06.021"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezaa149"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8191.2007.00467.x"},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2021.09.034"},{"key":"e_1_3_2_58_2","first-page":"63","article-title":"Twenty-year experience of aortic valve reimplantation using the Valsalva graft","author":"Chirichilli I","year":"2023","unstructured":"Chirichilli I, Scaffa R, Irace FG, et al. Twenty-year experience of aortic valve reimplantation using the Valsalva graft. Eur J Cardiothorac Surg 2023; 63.","journal-title":"Eur J Cardiothorac Surg"},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezab176"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2021.02.068"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2021.08.064"},{"key":"e_1_3_2_62_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2022.05.055"},{"key":"e_1_3_2_63_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivv354"},{"key":"e_1_3_2_64_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezy300"},{"key":"e_1_3_2_65_2","first-page":"17","volume-title":"Conference Proceedings Document From the Policy Conference on Pacemaker and ICD Performance","author":"Kappenberger L","year":"2005","unstructured":"Kappenberger L. Proceedings document from the Policy Conference on Pacemaker and ICD Performance. In: Conference Proceedings Document From the Policy Conference on Pacemaker and ICD Performance, Washington, DC, 2005. Washington (DC): Heart Rhythm Society: 17."},{"key":"e_1_3_2_66_2","unstructured":"Bavaria JE. TAVR update: new insights and perspectives from the U.S. National STS\/ACC TVT Registry https:\/\/www.sts.org\/sites\/default\/files\/102419%201645.%20Bavaria.%20TVT.pdf (2019 accessed 31 October 2025)."},{"key":"e_1_3_2_67_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2017.09.019"},{"key":"e_1_3_2_68_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.104.suppl_1.I-1"}],"container-title":["Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15569845261438464","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15569845261438464","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15569845261438464","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T10:08:00Z","timestamp":1784974080000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15569845261438464"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":67,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1177\/15569845261438464"],"URL":"https:\/\/doi.org\/10.1177\/15569845261438464","relation":{},"ISSN":["1556-9845","1559-0879"],"issn-type":[{"value":"1556-9845","type":"print"},{"value":"1559-0879","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]}}}