Search Strategy
On 30 August 2019, a systematic literature search was conducted in
MEDLINE, Embase, The Cochrane Collaboration and Web of Science, and
Google Scholar (Supplementary file 1). Studies published from January
2000 onwards were screened by two independent reviewers (BA, RvV) using
the following inclusion criteria: reporting morbidity and mortality
after bioprosthetic aortic root replacement with stentless (no
homografts) or stented prosthesis, cohorts ≥ 50 patients (to prevent
including early experience reports highlighting the learning curve), and
mean age at surgery ≥ 18 years. Exclusion criteria were: >
25% acute type A aortic dissection, studies limited to reintervention
or mechanical valve prosthesis, studies reporting only early results,
> 10% use of subcoronary technique, > 50%
children included (aged <18 years), and state of the art, case
reports, experimental studies and reviews. In case the same cohort was
published more than once, the most complete publication was selected.
All included studies were cross-referenced to identify additional
publications. In case of disagreement, studies were assessed by another,
independent reviewer (MV) and agreement was negotiated until consensus
was reached.