AORTLANTIC: French registry of aortic valve-sparing root replacement, preliminary multicentre results from western France

• Published in: Interactive cardiovascular and thoracic surgery Vol. 35; no. 5
• Main 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
• Format: Journal Article
• Language: English
• Published: Oxford University Press 10.10.2022
• Subjects: Vascular
• ISSN: 1569-9285; 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivac240

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.