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

Abstract

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. The aim of the study was to assess long‑term outcomes of aortic valve repair and aortic valve sparing procedures. 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. 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. 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.