ArticleEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2025
Aortic valve repair in adults: long-term clinical outcomes and echocardiographic evolution in different valve repair techniques.
Article in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Neocommissure plasty to treat aortic regurgitation due to commissural detachment in type 0 bicuspid aortic valve.JTCVS techniques · 2026Article
- Advances in surgical treatment for valvular heart disease: a narrative review of 2025 studies.Journal of thoracic disease · 2026Review
- FAPi-PET/CT as surrogate marker for subclinical myocardial fibrosis is a prognostic tool for patients undergoing left-sided heart valve surgery.EJNMMI research · 2026Article
- Asymptomatic Aortic Regurgitation: Evolving Imaging Markers and Contemporary Intervention Strategies.Journal of clinical medicine · 2026Review
- Trends of aortic valve-preserving surgery in japan: an updated five-year nationwide survey.General thoracic and cardiovascular surgery · 2025Article
- The Ross Procedure: Historical Context, Modern Outcomes, and the Road Ahead.Current cardiology reports · 2025Review
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Authors and funding
9 authors.
Funding
Abstract
objectivesAortic valve repair/sparing techniques have been established as effective treatments for aortic regurgitation and/or aortic aneurysms. However, concerns remain regarding long-term durability, reproducibility and patient selection. This study aims to asses long-term clinical and echocardiographic outcomes, with a focus on aortic regurgitation grade and left ventricular ejection fraction evolution, in adults undergoing these procedures.
methodsAdult patients in the Heart Valve Society Aortic Valve Database, undergoing any aortic valve repair/sparing technique were included. Time-to-event analyses were used for clinical outcomes and mixed-effects models for left ventricular ejection fraction and aortic regurgitation grade evolution. Techniques: isolated valve repair (group 1), ascending aortic replacement + valve repair (group 2), partial-root replacement ± valve repair (group 3) and valve-sparing root replacement ± valve repair (group 4).
resultsSurvival at 10 years was comparable to survival of the matched-general-population in each group. The 10-year cumulative incidence of reintervention was 19.5% [95% confidence interval (CI) 16.70-22.40%] in group 1 [including only double external annuloplasty in group 1; reintervention was not significantly different between techniques (P = 0.112)]; 13.8% (95% CI 10.10-18.10%) in group 2; 12.7% (95% CI 5.50-22.90%) in group 3; and 8.5% (95% CI 7.00-10.10%) in group 4 (P < 0.001). Severe preoperative aortic regurgitation grade [hazard ratio 1.95 (95% CI 1.19-3.21), P < 0.001] and left ventricular end-diastolic diameter [hazard ratio 1.03 (95% CI 1.00-1.05), P < 0.001] were predictive of reintervention in group 4; patch use was a predictor in all groups. The predicted left ventricular ejection fraction (%) initially increased (P < 0.001) and then stabilized.
conclusionsThis study found that aortic valve repair/sparing techniques provide viable and effective treatment options that should be considered for all eligible patients with aortic regurgitation and/or aortic root/ascending aortic aneurysms, given their potential to restore life expectancy and provide good haemodynamic outcomes with an acceptable hazard of reintervention.
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