The Journal of thoracic and cardiovascular surgery · 2026
Mid-term Outcomes after Aortic Valve Reimplantation with a Straight versus Valsalva Graft.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Tabrizi Nika Samadzadeh, Rosinski Brad F, Umana Holliann, Pasricha Aryan, Roselli Eric E, Koprivanac Marijan, Vargo Patrick, Lou Xiaoying, Bakaeen Faisal, Rajeswaran Jeevanantham, Curran Kelsey, Blackstone Eugene H, Griffin Brian, Desai Milind Y, Svensson Lars G
Аннотация
OBJECTIVES: To compare mid-term hemodynamic performance and durability of valve-sparing aortic root reimplantation (VSRR) using a Straight versus Valsalva graft.
METHODS: From 1/1/2000-12/1/2023, 1,495 adults without endocarditis underwent VSRR at Cleveland Clinic, of whom 838 (56%) received a Straight graft and 657 (44%) a Valsalva graft. Mean aortic valve gradient, aortic regurgitation grade, aortic valve reoperation, and survival were compared in 365 propensity-matched patient pairs (730 patients).
RESULTS: After matching (Straight vs Valsalva), operative mortality was 0.56% versus 0.28% (P=.56). At 5 years, mean aortic valve gradients were 6.6 versus 6.3 mmHg (P=.46) and prevalence of moderate or severe aortic regurgitation 12% versus 9.1% (P=.38). Straight grafts were associated with higher freedom from aortic valve reoperation overall (96% vs 94%, P=.045) and for structural valve deterioration (98% vs 95%, P[constant phase]=.019), at a rate of 0.27%/year versus 0.83%/year at 5 years. Concomitant aortic valve repair was more prevalent in patients receiving a Valsalva graft (37% vs 44%, P=.059), which carried a higher risk of reoperation (P[log-rank]=.0023; after adjusting for the confounding effect of concomitant aortic valve repair, P for risk of reoperation was .082).
CONCLUSIONS: Despite its increasing use in more complex and higher-risk patients, VSRR demonstrates excellent mid-term durability and hemodynamic performance, regardless of graft type. Higher risk of reoperation with Valsalva grafts likely reflects case mix and technical complexity.
METHODS: From 1/1/2000-12/1/2023, 1,495 adults without endocarditis underwent VSRR at Cleveland Clinic, of whom 838 (56%) received a Straight graft and 657 (44%) a Valsalva graft. Mean aortic valve gradient, aortic regurgitation grade, aortic valve reoperation, and survival were compared in 365 propensity-matched patient pairs (730 patients).
RESULTS: After matching (Straight vs Valsalva), operative mortality was 0.56% versus 0.28% (P=.56). At 5 years, mean aortic valve gradients were 6.6 versus 6.3 mmHg (P=.46) and prevalence of moderate or severe aortic regurgitation 12% versus 9.1% (P=.38). Straight grafts were associated with higher freedom from aortic valve reoperation overall (96% vs 94%, P=.045) and for structural valve deterioration (98% vs 95%, P[constant phase]=.019), at a rate of 0.27%/year versus 0.83%/year at 5 years. Concomitant aortic valve repair was more prevalent in patients receiving a Valsalva graft (37% vs 44%, P=.059), which carried a higher risk of reoperation (P[log-rank]=.0023; after adjusting for the confounding effect of concomitant aortic valve repair, P for risk of reoperation was .082).
CONCLUSIONS: Despite its increasing use in more complex and higher-risk patients, VSRR demonstrates excellent mid-term durability and hemodynamic performance, regardless of graft type. Higher risk of reoperation with Valsalva grafts likely reflects case mix and technical complexity.