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.