Kanika Kalra wins Best Resident Abstract Award at STS Meeting

January 2020

Kanika Kalra with Davide Pacini, MD, chair, Vascular Disease Domain, EACTS  (1st, left), Joseph Bavaria, MD, president, STS Foundation (2nd, left), Paul Kuznik, CEO, Terumo Aortic America (far left).

Kanika Kalra with Davide Pacini, MD, chair, Vascular Disease Domain, EACTS (1st, left), Joseph Bavaria, MD, president, STS Foundation (2nd, left), and Paul Kuznik, CEO, Terumo Aortic America (right).

Emory cardiothoracic surgery resident Kanika Kalra, MD, received the Society of Thoracic Surgeons/European Association for Cardio-Thoracic Surgery (STS/EACTS) Best Resident Abstract Presentation Award at the 56th STS Annual Meeting. She was first author of "Outcomes of valve-sparing root replacement versus traditional Bentall procedure in patients with aortic root aneurysms with non-stenotic bicuspid aortic valve," which was selected from over 70 abstracts on the topic of aortic valve repair and bicuspid valves. Edward Chen, MD, professor of surgery and executive director of the Emory Aortic Center, was senior author.

Aortic root aneurysms associated with non-stenotic bicuspid aortic valves (NS-BAV) can be repaired by Bentall root/valve replacement (ROOT) or valve sparing root replacement (VSRR), especially in younger patients. This study compared the procedural and long-term outcomes of these two techniques, as such data is sparse.

The patient cohort consisted of 158 patients with an aortic root aneurysm with an NS-BAV who underwent either VSRR or ROOT from March 2004 to January 2019. VSRR involved root replacement with optional aortic valve repair, while ROOT combined root replacement with either a bioprosthetic or mechanical heart valve replacement.

The study team found that postoperative stroke, renal failure, pneumonia, reoperation for bleeding, length of stay, and 30-day mortality were similar between the groups, though the rate of post-operative arrhythmias and blood transfusion requirement was lower in the VSRR group compared to ROOT. At discharge, none of the patients had more than mild aortic insufficiency (leaking of the valve). Long-term survival and cumulative incidence of aortic insufficiency, aortic stenosis, and re-operation was equivalent between the groups.

Dr. Kalra and her co-authors concluded that operative repair of NS-BAV can be achieved with acceptable clinical outcomes using either VSRR or ROOT. Despite being a more complex procedure, the team agreed that VSRR offers the advantage of preserving the native valve and should be considered in the surgical treatment of NS-BAV, especially in younger patients.