The role of neo‐sinus reconstruction in aortic valve‐sparing surgery

Aims The aim of this study was to evaluate the clinical and echocardiographic results and the predictors of outcomes in patients undergoing valve‐sparing operation (VSO) at two aortic centers. In addition, we sought to evaluate the potential effect of recreation of the sinuses of Valsalva (SV) on the outcome of valve‐sparing procedures. Methods During a 14‐year period, 328 patients underwent aortic valve‐sparing root replacement at two institutions. Clinical and echo evaluation was performed 6 months after surgery and every year thereafter or in case of clinical symptoms. Propensity weighting and propensity‐weighted risk competing analysis were used. Results No operative mortality was reported; the most common complication was revision for bleeding, occurring in 15 patients (4.6%). At a mean follow‐up of 30.0 ± 33.9 months, two patients died (0.6%). Recurrent aortic insufficiency (AI) >2+ was found in 11 patients (3.3%); five (1.5%) underwent reoperation. Recreation of the SV did not affect clinical outcome and aortic valve status. Need for aortic valve repair was the only independent predictor of recurrent AI, whereas a bicuspid aortic valve was a protective factor. Conclusions Re‐creation of the SV does not affect short‐term outcomes following VSO.