Aortic valve replacement in India. Early and long term results

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Surgery
• Aortic Valve Replacement

Background:

• Aortic valve replacement (AVR) is a critical procedure for managing aortic valve disease.
• Patient demographics and outcomes in AVR can vary significantly across different populations.
• Understanding outcomes in younger patient cohorts is essential for long-term management strategies.

Purpose of the Study:

• To present the experience and outcomes of aortic valve replacement in a cohort of predominantly young patients.
• To analyze early and long-term results, including mortality, morbidity, and survival rates.
• To compare findings with existing literature, particularly from Western reports.

Main Methods:

• Retrospective review of 261 patients undergoing aortic valve replacement.
• Data collection included patient demographics, preoperative conditions, surgical details, and postoperative outcomes.
• Follow-up data were collected for up to 12 years, with actuarial survival analysis.

Main Results:

• Mean patient age was 29.6 years, significantly younger than Western cohorts.
• Rheumatic fever history was noted in 53%; aortic regurgitation in 72.7%.
• Overall hospital mortality was 9.9%, decreasing to 4.5% in the last five years. Thrombo-embolic events occurred at 1.6 per 100 patient-years; paravalvar leak at 0.4%.
• Five-year and ten-year actuarial survival probabilities were 92.9% and 92.2%, respectively.

Conclusions:

• Aortic valve replacement in this young cohort demonstrated favorable early and long-term outcomes.
• Low mortality and complication rates, including thromboembolism and paravalvar leak, were observed.
• The findings suggest successful AVR in younger populations with significant long-term survival benefits.