ArticleJTCVS open2025
Annulus downsizing in valve-sparing aortic root replacement predicts aortic valve reoperation in children and young adults.
Article in JTCVS open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: Valve-sparing root replacement effectively treats aortic root pathology in adults, but data in pediatric patients are limited. We analyzed the midterm outcomes of valve-sparing root replacement in children and adolescents to define the risk factors for reintervention. Methods: From 2006 to 2023, 80 patients underwent valve-sparing root replacement at 15 [11-19] years; 31 had connective tissue disorders, and 34 had concomitant greater than mild regurgitation. The primary end points were postoperative aortic valve dysfunction and reintervention with secondary outcome of mortality. Root and graft diameters were compared using Cox regression to determine the effect of intraoperative sizing. Results: The reimplantation technique with straight-tube (n = 38) or Valsalva (n = 40) grafts was used in all patients (except n = 2 remodeling with straight-tube). Thirty-seven patients underwent concurrent valvuloplasty, and 62 patients underwent ascending aortic replacement. Two patients had more than mild regurgitation at discharge with no perioperative mortality. The most common complication was arrhythmia requiring medication (11%). At 3.6 [0.6-8.2] years follow-up, 4 patients died, 20 patients required reoperation (4 re-repairs, 16 replacements), and 13 patients developed more than mild regurgitation. At 12 years, freedom from death, reintervention, and recurrent regurgitation were 92.0% (80.0%-96.9%), 54.3% (36.1%-69.4%), and 48.7% (25.1%-68.7%). For every 0.1 decrease in ratio of graft size to preoperative annulus diameter, reintervention risk increased by 40% (hazard ratio, 1.40 [1.04-1.90], Conclusions: Valve-sparing root replacement is safe and effective for aortic root aneurysms in children and young adults. Early arrhythmias, recurrent regurgitation, and midterm reoperation remain concerns. Graft upsizing or leaflet modification should be considered if ratio of intended graft to preoperative diameter is less than 1.05. Preoperative imaging can guide appropriate graft selection and plication extent to mitigate reintervention risk associated with excessive downsizing.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.