Repeat aortic valve surgery: contemporary outcomes and risk stratification.

Area of Science:

• Cardiovascular Surgery
• Cardiac Surgery
• Thoracic Surgery

Background:

• Redo aortic valve surgery (rAVS) is increasingly common, often with higher mortality than primary procedures.
• Evaluating rAVS outcomes is crucial given the rise of transcatheter valve interventions.

Purpose of the Study:

• To assess current outcomes of redo aortic valve surgery.
• To establish a benchmark for rAVS in the context of emerging transcatheter techniques.

Main Methods:

• Retrospective review of 148 patients undergoing rAVS between 2000-2018.
• Analysis of indications, procedures, early mortality, and long-term survival.
• Identification of independent predictors for early and late mortality.

Main Results:

• Early mortality was 9.5%, with female gender, coronary disease, and lower creatinine predicting it.
• Long-term survival rates at 5, 10, and 14 years were 74.1%, 57.9%, and 43.8% respectively.
• Female gender, diabetes, coronary disease, and peripheral vascular disease independently impacted late survival.

Conclusions:

• Redo aortic valve surgery can achieve acceptable outcomes even in urgent cases with advanced functional class.
• Key risk factors for survival include female gender, coronary disease, and urgency.
• Few patients in this cohort would be suitable for transcatheter valve-in-valve procedures.