Acute type A aortic syndromes: outcomes are independent of aortic root/valve management

Purpose Clinical outcomes following various surgical intervention strategies for aortic root and valve pathology during repair of acute type A aortic syndromes were studied and compared. Methods From 2004 to 2019, 634 patients underwent acute type A aortic repair. Patients were divided into 4 groups: Valve Resuspension ( n = 456), Isolated Valve Replacement (AVR) ( n = 24), Valve and Root Replacement (ROOT) ( n = 97), and Valve Sparing Root Replacement (VSRR) ( n = 57). The primary endpoint was midterm survival and multivariable risk factor analysis was performed. Results The mean age was 55.4 ± 13 years, 424 (67%) were male, and overall early mortality was 12%. Early mortality was 13%, 8%, 11%, and 7% for the Valve Resuspension, AVR, ROOT, and VSRR groups respectively, p = 0.43. Five-year survival was 74%, 86%, 73%, and 84% for the Valve Resuspension, AVR, ROOT, and VSRR groups respectively, p = 0.46. There was no difference in late stroke, renal failure, heart block, and late bleeding ( p > 0.05 for all). At late follow-up, AVR and ROOT patients had a higher mean gradient versus Valve Resuspension and VSRR patients, p