Risk of valve-related events after aortic valve repair

Joel Price, Laurent De Kerchove, David Glineur, Jean Louis Vanoverschelde, Philippe Noirhomme, Gebrine El Khoury

Research output: Contribution to journalArticle

Abstract

Background: The impetus for aortic valve (AV) repair is to decrease valve-related complications in comparison to prosthetic valve replacement. However, relatively few data are available to confirm this hypothesis. We analyzed valve-related complications in a large series of patients undergoing AV repair. Methods: Between 1995 and 2010, 475 patients underwent elective AV repair for aortic insufficiency or aortic aneurysm. The mean age was 53 years, and 81% were male. Valve-related outcomes were defined as per published guidelines. Survival and freedom from valve-related events were reported using the Kaplan-Meier method and linearized event rates. Clinical follow-up was 98.3% complete with a mean follow-up time of 4.6 years. Results: Thirty-day mortality was 0.8% (n = 4). At 10 years, overall survival was 73% ± 5%, freedom from cardiac death was 81% ± 4%, and freedom from valve-related death was 90% ± 3%. Freedom from significant aortic insufficiency was 84% ± 3%. A total of 28 patients needed early (n = 7) or late (n = 21) AV reoperation; all of them survived reoperation, and 8 had repeat repair. Ten-year freedom from AV reoperation was 86% ± 3%, and freedom from AV replacement was 90% ± 3%. Freedom from AV reoperation was similar in tricuspid and bicuspid valve. During the follow-up period, linearized rate of thromboembolic event, bleeding, and AV endocarditis was 1.1%, 0.23%, and 0.19% per year, respectively. Ten-year freedom from valve-related events including AV reoperation, thromboembolic event, bleeding, and endocarditis was 74% ± 3%. Conclusions: The current findings confirm that AV repair is associated with low mortality, acceptable durability, and a low risk of valve-related events.

Original languageEnglish (US)
Pages (from-to)606-613
Number of pages8
JournalAnnals of Thoracic Surgery
Volume95
Issue number2
DOIs
StatePublished - Feb 1 2013

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Price, J., De Kerchove, L., Glineur, D., Vanoverschelde, J. L., Noirhomme, P., & El Khoury, G. (2013). Risk of valve-related events after aortic valve repair. Annals of Thoracic Surgery, 95(2), 606-613. https://doi.org/10.1016/j.athoracsur.2012.07.016