Hemostatic Properties of Aortic Root Preservation versus Root Replacement for Acute Type A Aortic Dissection: A Pooled Analysis

Journal article

ObjectiveWe reviewed the available literature on patients undergoing aortic repair for acute type A aortic dissection (ATAAD) with either aortic root preservation (RP) or root replacement (RR).MethodsOriginal research studies that evaluated short- and mid-term hemostatic properties of RP versus RR groups were identified, from 2000 to 2024. Intraoperative transfusions of red blood cells (RBCs), reoperation for bleeding, strategy of hemostatic sealing of the anastomosis in root repair following the reapproximation of the dissected layers of the aortic wall (with/without biological glue), and operative mortality were the primary endpoints. Postoperative morbidity and overall and reoperation-free survival at one and five years were the secondary endpoints. A sensitivity analysis was performed using the leave-one-out method.ResultsTen studies were included in the qualitative and quantitative synthesis, incorporating data from 6850 patients (RP: 4389 patients; RR: 2461 patients). Root preservation demonstrated a lower median transfusion of RBCs (WMD: -1.00; 95% CI: -1.41, -0.59; p p ConclusionsRoot preservation without the use of biological glue during aortic repair is associated with enhanced hemostatic traits compared to the root replacement approach. A future well-designed Randomized Controlled Trial should further validate our outcomes.

Authors: Magouliotis, DE; Arjomandi Rad, A; Viviano, A; Oo, AY; Xanthopoulos, A

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: MDPI
• Journal: Life
• Volume: 14
• Issue: 10
• Pages: 1255
• Publication date: 2024-10-01
• Acceptance date: 2024-09-30
• DOI: 10.3390/life14101255
• EISSN: 2075-1729
• ISSN: 2075-1729
• Pmid: 39459555
• Language: English
• Keywords: Ataad; Root Preservation; Aortic Repair; Aortic Dissection; Valve Sparing; Bentall; Root Replacement