• Fernando de Azevedo Lamana, Ricardo Ribeiro Dias, Jose Augusto Duncan, Leandro Batisti de Faria, Luiz Marcelo Sa Malbouisson, Luciano de Figueiredo Borges, Charles Mady, and Fábio Biscegli Jatene.
• Universidade Federal de Minas Gerais, Belo Horizonte, MG, BR.
• Rev Bras Cir Cardiovasc. 2015 Sep 1;30(3):343-52.

ObjectiveTo compare the results of the root reconstruction with the aortic valve-sparing operation versus composite graftvalve replacement.MethodsFrom January 2002 to October 2013, 324 patients underwent aortic root reconstruction. They were 263 composite graft-valve replacement and 61 aortic valve-sparing operation (43 reimplantation and 18 remodeling). Twenty-six percent of the patients were NYHA functional class III and IV; 9.6% had Marfan syndrome, and 12% had bicuspid aortic valve. There was a predominance of aneurysms over dissections (81% vs. 19%), with 7% being acute dissections. The complete follow-up of 100% of the patients was performed with median follow-up time of 902 days for patients undergoing composite graft-valve replacement and 1492 for those undergoing aortic valve-sparing operation.ResultsIn-hospital mortality was 6.7% and 4.9%, respectively for composite graft-valve replacement and aortic valve-sparing operation (ns). During the late follow-up period, there was 0% moderate and 15.4% severe aortic regurgitation, and NYHA functional class I and II were 89.4% and 94%, respectively for composite graft-valve replacement and aortic valve-sparing operation (ns). Root reconstruction with aortic valve-sparing operation showed lower late mortality (P=0.001) and lower bleeding complications (P=0.006). There was no difference for thromboembolism, endocarditis, and need of reoperation.ConclusionThe aortic root reconstruction with preservation of the valve should be the operation being performed for presenting lower late mortality and survival free of bleeding events.

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