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Page 10 of 11 Perezgrovas-Olaria et al. Vessel Plus 2023;7:10 https://dx.doi.org/10.20517/2574-1209.2022.54

This study must be interpreted considering its limitations. This is an observational study and lacks the rigor
of a randomized controlled trial. Additionally, this represents the experience of a single high-volume aortic
center. Moreover, thromboembolic and hemorrhagic events, as well as echocardiographic data, are not
collected in our database and could not be included in the present analysis. On the other hand, prospective
data collection in our institutional database and a large population are strengths of the present study.

In Conclusion, The Bentall-De Bono operation can be performed with consistently good results in
experienced centers. Early outcomes are excellent regardless of the valve choice. In our study, the Bentall-De
Bono operation with bCVG was associated with lower 10-year mortality but carried a higher risk of aortic
reoperation. While the risk of reoperation is largely tied to valve choice, survival is more likely to be
influenced by patient comorbidities and risk factors.

DECLARATIONS
Authors’ contributions
Conception of the manuscript: Gaudino M, Lau G, Girardi LN
Data extraction: Cancelli G, Yaghmour M, Polk H, Closkey B, Wright J
Writing the first draft of manuscript: Perezgrovas-Olaria R, Soletti G Jr, Harik L, Dimagli A
Statistical analysis: Rahouma M, Dimagli A
Writing and Revision of the main manuscript: All authors.

Availability of data and materials
Deidentified data collected for the study will be made available by the corresponding author upon
reasonable request after publication.

Financial support and sponsorship
Cancelli G. is supported by the Enrico ed Enrica Sovena Foundation, Italy.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
This analysis was approved by the Weill Cornell Institutional Review Board (#1607017424, January 9, 2022)
in New York. The need for individual consent was waived.

Consent for publication
Written informed consent for inclusion in our institutional database and subsequent publication was
provided by all the patients in this analysis. No personal identifying information for any patient is provided
in this work.

Copyright
© The Author(s) 2023.

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3. Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J