Why I choose to repair and not to replace the aortic valve?
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Aortic valve replacement whether surgical or transcutaneous remains an option for the treatment of severe aortic valve disease; however, current prosthetic devices are associated with complications including, but no limited to, valve thrombosis and thromboembolic events, bleeding events associated with anticoagulation use, prosthetic valve endocarditis and structural valve deterioration. In this effect, aortic valve repair (AVr) has become an attractive alternative in circumventing these potential complications by preservation of the native aortic valve apparatus. In this article, we attempt to present the progress made for AVr over the last two decades. We also wish to highlight the critical steps for successful AVr and the outcome data that demonstrate that can be first-choice treatment in selected patients and finally to emphasize on the key steps for further future development.
KeywordsAortic valve Aortic valve repair
Aortic valve repair
Class of recommendation
Level of evidence
Left ventricular ejection fraction
Left ventricular end systolic dimension
Left ventricular end diastolic dimension
Functional aortic annulus
Composite valve graft
Transcatheter aortic valve implantation
- 3.David TE, Feindel CM. An aortic valve—sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta. J Thorac Cardioavasc Surg 1992;103:617–21 (discussion 622).Google Scholar
- 14.Nashimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Fleisher LA, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association task force on clinical practise guidelines. J Am Coll Cardiol. 2017;70(2):252–89.CrossRefGoogle Scholar
- 15.Swenson LG, Adams DH, Bonow RO, Kouchoukos NT, Miller DC, O’Gara PT, et al. Aortic valve and ascending aorta guidelines for management and quality measures: executive summary. Ann Thorac Surg 2013;95:1491–505 (This Society of Thoracic Surgeons Guidelines document an up to date summary of indications for ascending aorta intervention).CrossRefGoogle Scholar