Valvular & structural heart disease
Feasibility of valve-in-root transcatheter aortic valve implantation in patients with prior aortic root replacement and repair
Authors' conclusion
The feasibility of a future transcatheter valve-in-root procedure depends on the anatomical conditions of the aortic root after the initial operation.
Study context
- Population
- Patients after valve-sparing root repair (VSRR) or Bio-Bentall procedure (2012–2022) with postoperative CT angiography, assessed for future transcatheter valve-in-root implantationof 537 operated
- Participants
- 363 patients
- Exposure
- VSRR vs Bio-Bentall
- VSRRn = 250
- Bio-Bentalln = 113
- Outcome
- Feasibility of transcatheter valve-in-root implantation (annulus area, annulus-to-coronary distance, coronary ostium size, valve-to-coronary distance) on postoperative CT angiography
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
| Group | Annulus area >840 mm² (unsuitable) | Annulus-to-coronary distance, RCA | Annulus-to-coronary distance, LCA | Annulus area <300 mm² (risk of patient-prosthesis mismatch) |
|---|---|---|---|---|
| VSRR | 4.8% | 18.0±5.8 mm | 11.6±4.6 mm | |
| Bio-Bentall | 12.5±5.4 mm | 8.0±4.5 mm | 12.4% |
Annulus area >840 mm² (unsuitable)
VSRR4.8%
Bio-Bentall— not stated in the abstract
Annulus-to-coronary distance, RCA
VSRR18.0±5.8 mm
Bio-Bentall12.5±5.4 mm
Annulus-to-coronary distance, LCA
VSRR11.6±4.6 mm
Bio-Bentall8.0±4.5 mm
Annulus area <300 mm² (risk of patient-prosthesis mismatch)
VSRR— not stated in the abstract
Bio-Bentall12.4%
- VSRR vs Bio-Bentall: P < 0.001 — annulus-to-coronary distance, RCA
- VSRR vs Bio-Bentall: P < 0.001 — annulus-to-coronary distance, LCA
Observational data: associations, not effects.
Further findings
VTC to LCA after Bio-Bentall, by graft type
P < 0.001
VTC <4 mm among coronary ostia below upper frame level
- Coronary ostia below upper frame level with VTC <4 mm (of 98 ostia)
- 63.3%
Original publication
Feasibility of valve-in-root transcatheter aortic valve implantation in patients with prior aortic root replacement and repair. EuroIntervention. Published 15 December 2025. doi:10.
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