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Multicenter Study
. 2022 Oct 10;35(5):ivac240.
doi: 10.1093/icvts/ivac240.

AORTLANTIC: French registry of aortic valve-sparing root replacement, preliminary multicentre results from western France

Clément Dubost  1 , Jacques Tomasi  2 , Antoine Ducroix  3 , Kevin Pluchon  4 , Pierre Escrig  2 , Olivier Fouquet  3 , Arthur Aupart  5 , Alain Mirza  6 , Imen Fellah  1 , Eric Bezon  4 , Christophe Baufreton  3 , Jean Marc El Arid  5 , Jean-Christian Roussel  1 , Jean-Philippe Verhoye  2 , Thomas Senage  1
Affiliations
Multicenter Study

AORTLANTIC: French registry of aortic valve-sparing root replacement, preliminary multicentre results from western France

Clément Dubost et al. Interact Cardiovasc Thorac Surg. .

Abstract

Objectives: Aortic root aneurysms often affect younger patients in whom valve-sparing surgery is challenging. Among current techniques, aortic valve-sparing root replacement described by Tirone David has shown encouraging results. The AORTLANTIC registry was instituted for a multicentre long-term evaluation of this procedure. The current initial study evaluates the hospital outcomes of the procedure.

Methods: This is a retrospective study of patients operated between 1 January 2004 and 31 December 2020 in 6 hospitals in western France. All study data were recorded in the national digital database of the French Society of Cardiac Surgery: EPICARD.

Results: A total of 524 consecutive patients with a mean age of 53 (15.1) years underwent surgery. 13% (n = 68) of patients presented with acute aortic dissection, 16.5% (n = 86) had associated connective tissue pathology and 7.3% (n = 37) had bicuspid aortic valves. Preoperative aortic regurgitation (AR) ≥2/4 was present in 65.3% (n = 341) of patients. Aortic valvuloplasty was required in 18.6% (n = 95) of patients. At discharge, 92.8% (n = 461) of patients had no or 1/4 AR. The stroke rate was 1.9% (n = 10). Intra-hospital mortality was 1.9% (n = 10).

Conclusions: The AORTLANTIC registry includes 6 centres in western France with >500 patients. Despite numerous complex cases (acute aortic dissections, bicuspid aortic valves, preoperative AR), aortic valve-sparing root replacement has a low intra-hospital mortality. The initial encouraging results of this multicentre study warrant further long-term evaluation by future studies.

Keywords: Acute aortic dissection; Aortic regurgitation; Bicuspid aortic valve; David procedure; French multicentric registry; Valve-sparing aortic root replacement.

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