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

Abstract

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 The aim of the study was to assess long-term outcomes 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, including 452 (89.7%) elective and 52 (10.3%) emergency surgeries for acute type A aortic dissections. Median (interquartile range) age was 59 (35-66) years, 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 dissection, 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 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.