Conclusion
This study provides an overview of contemporary outcome after
bioprosthetic aortic root replacement and demonstrates impaired survival
and notable valve-related events, irrespective of the type of valve
prosthesis. Thromboembolic events occur relatively frequent and may be
associated with higher thrombogenicity of the biological valve, at least
in the early postoperative period. This should be considered when
choosing the most optimal treatment, especially in younger patients.
Given the observed heterogeneity of the pooled study results, in-depth
analysis of potential risk factors remains challenging. It requires a
collective international effort employing uniform data definitions and
high quality data collection, to push forward the knowledge on outcomes
and provide clues toward optimization of treatment selection for
patients requiring aortic root replacement
(59). Nevertheless, this study provides
comprehensive outcome and may be used as a benchmark to compare with
other types of procedures (e.g. Bentall or valve-sparing procedures).
Data availability statementThe data that support the findings of this study are available at
PubMed, at https://pubmed.ncbi.nlm.nih.gov, references are the studies
included into this systematic review. These data were derived from the
following resources available in the public domain: MEDLINE (PubMed),
Embase, The Cochrane Collaboration and Web of Science, and Google
Scholar.