Long-term outcomes of aortic valve repair in over 500 consecutive patients: single-center experience

Radosław Gocoł, Marcin Malinowski, Jarosław Bis, Damian Hudziak, Joanna Ciosek, Wojciech Wojakowski, Ewa Gaszewska-Żurek, Marek Jasiński, Marek A Deja
Kardiologia Polska 2020 June 2

BACKGROUND: Over the last years aortic valve repair has evolved from being a random and irreproducible procedure to a standardized technique yielding durable long-term results.

AIMS: Long-term outcome of aortic valve repair and aortic valve sparing procedures.

METHODS: We analyzed the outcomes of all consecutive patients who underwent aortic valve repair and/or aortic valve sparing root replacement till the end of 2019. We assessed mortality, freedom from reoperation and freedom from at least moderate aortic valve regurgitation.

RESULTS: A total of 504 patients underwent aortic valve repair and/or aortic valve sparing root replacement over 17 years period, including 452 (89.7%) elective and 52 (10.3%) emergency surgeries for acute type A aortic dissections. Median age was 59 years (IQR 35;66), 72.4% were male. Median follow-up time was 35 months. Estimated 5-year survival was 83%, and 10-year survival was 73%. In 452 patients after elective surgery the estimated actuarial 5-year and 10-year survival was 86% and 75%, respectively. In patients after emergency surgery for acute type A aortic actuarial 5-year survival was 62%, and 10-year survival was 62%. Estimated 5- and 10-year freedom from reoperation was 96% and 87%, respectively. The comparison of both subgroups did not reveal significant differences (P = 0.42). Freedom from at least moderate aortic valve regurgitation was confirmed in 86.6% of patients.

CONCLUSIONS: Aortic valve repair is a durable and effective surgical procedure associated with low early and late mortality. Aortic valve reconstruction in patients with acute type A aortic dissection yields good long-term results.

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