Comparison of outcomes following valve-sparing aortic root replacement in patients with bicuspid and tricuspid aortic valves: A meta-analysis
Abstract
BACKGROUND
Aortic root dilation, linked to bicuspid aortic valve (BAV) or tricuspid aortic valve (TAV), risks aneurysm and dissection. Valve-sparing aortic root replacement (VSARR) preserves native valves, avoiding prosthetic valve complications. Long-term VSARR durability, especially in BAV patients, is debated. We hypothesize that VSARR outcomes differ between BAV and TAV patients in short-term and long-term settings.
AIM
To investigate short-term and long-term outcomes of VSARR in BAV vs TAV patients.
METHODS
This Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant meta-analysis included observational studies comparing VSARR in adult BAV vs TAV patients. PubMed, ScienceDirect, and EMBASE were searched from inception to June 2025. Outcomes included mortality, reintervention, and procedural times. Pooled relative risk (RR) and mean differences (MD) with 95%CI were calculated. Risk of bias was assessed using Risk of Bias in Non-randomized Studies of Interventions; evidence certainty via GRADE.
RESULTS
Thirteen observational studies involving 1419 BAV and 2349 TAV patients were included. In-hospital mortality (RR = 0.34, 95%CI: 0.10–1.14, P = 0.08) and reoperation (RR = 1.04, 95%CI: 0.64–1.69, P = 0.87) showed no significant differences. All-cause mortality risk was significantly lower in BAV patients (RR = 0.34, 95%CI: 0.13–0.86, P = 0.02). Overall reintervention risk was significantly greater in BAV patients (RR = 2.64, 95%CI: 1.96–3.55, P <…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,349 participants or records.
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