Regurgitant Bicuspid Aortopathy - Is Valve sparing root replacement equivalent to Bentall Procedure?

Abstract Background Repair of aortic root aneurysms with non-stenotic bicuspid valves (NS-BAV) is achieved either with valve sparing root replacement (VSRR) or conventional Bentall (ROOT). Procedural and long-term outcomes comparing these two techniques are sparse and need investigation. Methods From March 2004 to January 2019, 158 patients with an aortic root aneurysm and NS-BAV underwent VSRR (n=78,49.3%) or ROOT (n=80,50.6%). VSRR involved optional aortic valve repair (n=47,60%), and ROOT was performed with bioprosthetic (81.3%) or mechanical valve replacement (18.7%). Procedural and post-operative outcomes were obtained, and univariate and Kaplan-Meier analyses were performed. Results VSRR patients were younger (42.7±12.0 years) than ROOT (54.8±13.6 years, p Conclusions Surgery for aortopathy associated with NS-BAV is safe and effective with either VSRR or ROOT. Despite its complexity, VSRR should be considered in the surgical treatment of this population.