Why and when to repair the aortic valve? Jan Vojacek, M.D., Ph.D. Professor of Cardiac Surgery Department of Cardiac Surgery, Charles University University Hospital Hradec Kralove Czech Republic Reconstruction of the Aortic Valve and Root: A practical approach Homburg, September 18 – 20, 2019
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Why and when to repair the aortic valve? · 2019. 9. 18. · Arabkhani et al. Reported Outcome After Valve-Sparing Aortic Root Replacement for Aortic Root Aneurysm: A Systematic Review
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Why and when to repair the aortic valve?
Jan Vojacek, M.D., Ph.D.Professor of Cardiac Surgery
Department of Cardiac Surgery, Charles UniversityUniversity Hospital Hradec Kralove
Czech Republic
Reconstruction of the Aortic Valve and Root: A practical approach
David TE et al. A quarter of a century of experience with aortic valve-sparing operations. J Thorac Cardiovasc Surg 2014;148:872-80
Freedom from ReDo at
18 years: 94.8%
In Hospital mortality: 1%
371 patients
The long-term results of VSARR
Schäfers et al. Reexamining remodeling. J Thorac CardiovascSurg 2015;149:S30-6
747 patientsIn-Hospital mortality: 2%
Freedom from ReDo in tricuspid aortic valve at 15 years: 95%
The long-term results of VSARR
Arabkhani et al. Reported Outcome After Valve-Sparing Aortic Root Replacement for Aortic Root Aneurysm: A Systematic Review and Meta-Analysis. Ann Thorac Surg 2015Sep;100(3):1126-31.
Cumulative risk of hemorrhage, TE = 0,64 (6% at 10 years)
The long-term results of VSARR
Arabkhani et al. Reported Outcome After Valve-Sparing Aortic Root Replacement for Aortic Root Aneurysm: A Systematic Review and Meta-Analysis. Ann Thorac Surg 2015Sep;100(3):1126-31.
Risk of ReDo: 13% at 10 years
Aicher D et al. Aortic valve repair leads to a low incidence of valve-related complications. Eur J Cardiothorac
Surg. 2010 Jan;37(1):127-32.
Freedom from all valve-related complications
(88%)
The long-term results of aortic valve repair
Aicher D et al. Aortic valve repair leads to a low incidence of valve-related complications. Eur J Cardiothorac Surg.
Only moderate degenerative changes- limited calcification
Not restricted leaflets (gH)
Unicuspid aortic valve
Thank you for your attention
The long-term results of VSARR and the Bentall procedure
Mookhoek A et al. Bentall Procedure: A Systematic Review and Meta-Analysis. Ann ThoracSurg. 2016 Feb 5. pii: S0003-4975(15)01762-2.
Bentall VSARR
Reoperation 0,7%yr 1,32%yr
TE 1,1%yr 0,4%yr
Bleeding 1,0%yr 0,2%yr
Linearized risk of late outcome events
Arabkhani et al. Reported Outcome After Valve-Sparing Aortic Root Replacement for Aortic Root Aneurysm: A Systematic Review and Meta-Analysis. Ann Thorac Surg 2015Sep;100(3):1126-31.
The long-term results of VSARR and the Bentall procedure
Mookhoek A et al. Bentall Procedure: A Systematic Review and Meta-Analysis. Ann ThoracSurg. 2016 Feb 5. pii: S0003-4975(15)01762-2.
Bentall VSARR
Reoperation 0,7%yr 1,32%yr
TE 1,1%yr 0,4%yr
Bleeding 1,0%yr 0,2%yr
Linearized risk of late outcome events
Arabkhani et al. Reported Outcome After Valve-Sparing Aortic Root Replacement for Aortic Root Aneurysm: A Systematic Review and Meta-Analysis. Ann Thorac Surg 2015Sep;100(3):1126-31.
The long-term results of VSARR and the Bentall procedure
Mookhoek A et al. Bentall Procedure: A Systematic Review and Meta-Analysis. Ann ThoracSurg. 2016 Feb 5. pii: S0003-4975(15)01762-2.
Bentall VSARR
Reoperation 0,7%yr 1,32%yr
TE 1,1%yr 0,4%yr
Bleeding 1,0%yr 0,2%yr
Linearized risk of late outcome events
Arabkhani et al. Reported Outcome After Valve-Sparing Aortic Root Replacement for Aortic Root Aneurysm: A Systematic Review and Meta-Analysis. Ann Thorac Surg 2015Sep;100(3):1126-31.
The long term results of mechanical and bioprosthetic AVR
Oxenham H et al. Twenty year comparison of a Bjork-Shiley mechanical heart valve with porcine bioprostheses. Heart, 2003.