AORTLANTIC: French registry of aortic valve-sparing root replacement, preliminary multicentre results from western France. (29th September 2022)

• Record Type: Journal Article
• Authors: Dubost, Clément; Tomasi, Jacques; Ducroix, Antoine; Pluchon, Kevin; Escrig, Pierre; Fouquet, Olivier; Aupart, Arthur; Mirza, Alain; Fellah, Imen; Bezon, Eric; Baufreton, Christophe; El Arid, Jean Marc; Roussel, Jean-Christian; Verhoye, Jean-Philippe; Senage, Thomas
• Is Part Of: Interactive cardiovascular and thoracic surgery. Volume 35:Number 5(2022)
• Publication Date: 2022-09-29
• Subjects: Valve-sparing aortic root replacement -- David procedure -- Acute aortic dissection -- Aortic regurgitation -- Bicuspid aortic valve -- French multicentric registry; Chest -- Surgery -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; 616.1
• DOI: 10.1093/icvts/ivac240
• Languages: English
• ISSNs: 1569-9293

Abstract

Abstract: OBJECTIVES: Aortic root aneurysms often affect younger patients in whom valve-sparing surgery is challenging. Among current techniques, aortic valve-sparing root replacement described by Tirone David has shown encouraging results. The AORTLANTIC registry was instituted for a multicentre long-term evaluation of this procedure. The current initial study evaluates the hospital outcomes of the procedure. METHODS: This is a retrospective study of patients operated between 1 January 2004 and 31 December 2020 in 6 hospitals in western France. All study data were recorded in the national digital database of the French Society of Cardiac Surgery: EPICARD. RESULTS: A total of 524 consecutive patients with a mean age of 53 (15.1) years underwent surgery. 13% ( n = 68) of patients presented with acute aortic dissection, 16.5% ( n = 86) had associated connective tissue pathology and 7.3% ( n = 37) had bicuspid aortic valves. Preoperative aortic regurgitation (AR) ≥2/4 was present in 65.3% ( n = 341) of patients. Aortic valvuloplasty was required in 18.6% ( n = 95) of patients. At discharge, 92.8% ( n = 461) of patients had no or 1/4 AR. The stroke rate was 1.9% ( n = 10). Intra-hospital mortality was 1.9% ( n = 10). CONCLUSIONS: The AORTLANTIC registry includes 6 centres in western France with >500 patients. Despite numerous complex cases (acute aortic dissections, bicuspid aortic valves, preoperative AR), aortic valve-sparing root replacement has a low intra-hospital mortality. The initial encouraging results of this multicentre study warrant further long-term evaluation by future studies. Abstract : Aortic aneurysm pathology is a silent disease that can affect young people, especially Marfan patients.