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Aortic Valve Surgery in Nonelderly Patients: Insights Gained From AVIATOR
- Source :
- Seminars in Thoracic and Cardiovascular Surgery, 31(4), 643-649. W.B. Saunders, Seminars in thoracic and cardiovascular surgery, Vol. 31, no.4, p. 643-649 (2021)
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Aortic valve surgery in non-elderly patients represents a very challenging patient population. The younger the patient is at the point of aortic valve intervention, the longer their anticipated life expectancy will be, with longer exposure to valve-related complications and risk for re-operation. Although the latest international guidelines recommend aortic valve repair in patients with aortic valve insufficiency, what we see in the real world is that the vast majority of these aortic valves are replaced. However, current prosthetic valves has now been shown to lead to significant loss of life expectancy for non-elderly patients up to 50% for patients in their 40s undergoing mechanical aortic valve replacement. Bioprostheses carry an even worse long-term survival, with higher rates of re-intervention. The promise of trans-catheter valve-in-valve technology is accentuating the trend of bioprosthetic implantation in younger patients, without yet the appropriate evidence. In contrast, aortic valve repair has shown excellent outcomes in terms of quality of life, freedom from re-operation and freedom from major adverse valve-related events with similar life expectancy to general population as it is also found for the Ross procedure, the only available living valve substitute. We are at a time when the paradigm of aortic valve surgery needs to change for the better. To better serve our patients, we must acquire high quality real-world evidence from multiple centers globally - this is the vision of the AVIATOR registry and our common responsibility.
- Subjects :
- Aortic valve
Time Factors
Nonelderly patients
medicine.medical_treatment
Heart Valve Diseases
AVIATOR
Aortic valve surgery
Adult
Age Factors
Aortic Valve
Bioprosthesis
Evidence-Based Medicine
Heart Valve Prosthesis
Life Expectancy
Middle Aged
Prosthesis Failure
Recovery of Function
Registries
Risk Factors
Treatment Outcome
Heart Valve Prosthesis Implantation
Transcatheter Aortic Valve Replacement
030204 cardiovascular system & hematology
0302 clinical medicine
Aortic valve repair
Quality of life
Expectancy theory
education.field_of_study
Ross procedure
General Medicine
medicine.anatomical_structure
Cardiology and Cardiovascular Medicine
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Population
03 medical and health sciences
medicine
Humans
education
business.industry
Mechanical Aortic Valve
Surgery
Settore MED/23
030228 respiratory system
Life expectancy
business
Subjects
Details
- ISSN :
- 10430679
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- Seminars in Thoracic and Cardiovascular Surgery
- Accession number :
- edsair.doi.dedup.....e226d2500008a475f8131e9947327d83