AORTLANTIC: French registry of aortic valve-sparing root replacement, preliminary multicentre results from western France

International audience; OBJECTIVES: Aortic root aneurysms often affect younger patients in whom valve-sparing surgery is challenging. Amongst current techniques, aortic valve-sparing root replacement described by Tirone David has shown encouraging results. The AORTLANTIC registry was instituted for a multicentre long-term evaluation of this procedure. The current initial study evaluates the hospital outcomes of the procedure. MATERIAL AND METHOD: This is a retrospective study of patients operated between January 01, 2004, and December 31, 2020, in 6 hospitals in western France. All study data were recorded in the national digital database of the French Society of Cardiac Surgery: EPICARD. RESULTS: 524 consecutive patients with a mean age of 53(15.1) years underwent surgery. 13% (n = 68) patients presented with acute aortic dissection, 16.5% (n = 86) had associated connective tissue pathology and 7.3% (n = 37) had bicuspid aortic valves. Preoperative aortic regurgitation ≥ 2/4 was present in 65.3% (n = 341) of patients. Aortic valvuloplasty was required in 18.6% (n = 95) patients. At discharge, 92.8% (n = 461) patients had no or 1/4 aortic regurgitation. The stroke rate was 1.9% (n = 10). Intra-hospital mortality was 1.9% (n = 10). CONCLUSION: The AORTLANTIC registry includes 6 centers in western France with more than 500 patients. Despite numerous complex cases (acute aortic dissections, bicuspid aortic valves, preoperative aortic regurgitation), aortic valve-sparing root replacement has a low intra-hospital mortality. The initial encouraging results of this multicentre study warrant further long-term evaluation by future studies. CLINICAL REGISTRATION NUMBER: Nov 2021: This registry was approved by an ethics committee mandated by the CNIL (Commission Nationale de l’Informatique et des Libertés) to approve scientific projects of the Nantes Hospital Centre.