Search Strategy
On 30 August 2019, a systematic literature search was conducted in MEDLINE, Embase, The Cochrane Collaboration and Web of Science, and Google Scholar (Supplementary file 1). Studies published from January 2000 onwards were screened by two independent reviewers (BA, RvV) using the following inclusion criteria: reporting morbidity and mortality after bioprosthetic aortic root replacement with stentless (no homografts) or stented prosthesis, cohorts ≥ 50 patients (to prevent including early experience reports highlighting the learning curve), and mean age at surgery ≥ 18 years. Exclusion criteria were: > 25% acute type A aortic dissection, studies limited to reintervention or mechanical valve prosthesis, studies reporting only early results, > 10% use of subcoronary technique, > 50% children included (aged <18 years), and state of the art, case reports, experimental studies and reviews. In case the same cohort was published more than once, the most complete publication was selected. All included studies were cross-referenced to identify additional publications. In case of disagreement, studies were assessed by another, independent reviewer (MV) and agreement was negotiated until consensus was reached.