Aortic valve surgery is a common procedure used to treat significant aortic valve stenosis or insufficiency. Some of these patients have coexisting pathology affecting the ascending aorta requiring ascending aorta replacement (AAR). Although the outcomes of these procedures are independently positive, it is proposed that concomitant AAR improves outcomes and minimizes the chances of future ascending aorta replacement. A comprehensive literature search for relevant studies published since 2010 comparing outcomes of aortic valve repair and replacement with or without concomitant ascending aorta replacement was undertaken using electronic databases PubMed, Cochrane Library, Embase Ovid, and SCOPUS. Major exclusion criteria were (1) conference posters, literature reviews, editorials; (2) aortic root surgery, aortic arch surgery, or other surgeries (3) case series with less than 5 participants. A total of 1189 patients from 6 retrospective cohort studies were included in the final review, from which clinical outcomes such as mortality and complications were compared. Mortality rates were similar in both intervention groups. No significant differences were found between the 2 groups in reexploration rates due to bleeding, stroke, postoperative dialysis, and atrial fibrillation. Survival rates varied but had no significant difference between interventions. Both isolated aortic valve surgery and concomitant AAR procedures offer comparable favourable outcomes in terms of mortality, survival rates, and complication risks. However, the evidence is limited by the lack of randomized controlled trials. We recommend that future studies should standardize reporting on postoperative recovery, complications, long-term freedom from reoperations, and long-term changes to aorta dimensions.

中文翻译：

---

主动脉瓣置换和修复伴或不伴升主动脉置换：对结果的影响：系统评价。

主动脉瓣手术是用于治疗严重主动脉瓣狭窄或关闭不全的常见手术。其中一些患者存在影响升主动脉的共存病理，需要升主动脉置换术（AAR）。尽管这些手术的结果独立地是积极的，但建议同时进行 AAR 可以改善结果并最大限度地减少未来升主动脉置换的机会。使用电子数据库 PubMed、Cochrane Library、Embase Ovid 和 SCOPUS 对 2010 年以来发表的相关研究进行了全面的文献检索，比较了主动脉瓣修复和置换术伴或不伴升主动脉置换术的结果。主要排除标准为（1）会议海报、文献综述、社论；(2) 主动脉根部手术、主动脉弓手术或其他手术 (3) 少于 5 名参与者的病例系列。最终审查纳入了来自 6 项回顾性队列研究的总共 1189 名患者，比较了死亡率和并发症等临床结果。两个干预组的死亡率相似。两组因出血、卒中、术后透析和心房颤动导致的再次探查率没有显着差异。存活率各不相同，但干预措施之间没有显着差异。孤立主动脉瓣手术和伴随的 AAR 手术在死亡率、生存率和并发症风险方面都提供了相当良好的结果。然而，由于缺乏随机对照试验，证据有限。我们建议未来的研究应标准化关于术后恢复、并发症、长期免于再次手术以及主动脉尺寸长期变化的报告。