Starting an aortic valve repair program: is it worthwhile? Aortic valve repair compared to replacement

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Surgical Outcomes

Background:

• Aortic valve (AV) repair may offer superior long-term outcomes compared to AV replacement for aortic insufficiency.
• Existing literature primarily comes from specialized centers and lacks replication in emerging programs.

Purpose of the Study:

• To evaluate the short-term outcomes of a newly established AV repair program.
• To compare AV sparing surgery versus AV replacement in a single-center experience.

Main Methods:

• Retrospective cohort study of 107 patients undergoing elective AV surgery (2013-2018).
• Exclusion of critically ill patients, endocarditis, aortic stenosis, or redo surgery.
• Propensity score matching created comparable groups of 23 patients for repair and replacement.

Main Results:

• AV repair group (n=23) had 1 death and 2 reoperations; replacement group (n=23) had 0 deaths and 1 reoperation.
• Longer cross-clamp and bypass times for repair, but shorter ventilation and hospital stay.
• Comparable aortic regurgitation and freedom from major complications; lower gradients post-repair.

Conclusions:

• Early results indicate the feasibility of replicating experienced centers' outcomes in nascent AV repair programs.
• AV repair demonstrates comparable safety and efficacy in a developing program.