ABSTRACT
BACKGROUND: Results and durability of aortic valve replacement in aortic stenosis are well known, but no study has focused on the results of aortic valve replacement in aortic insufficiency. AIM: The aim of this retrospective study was to describe our mid-term outcomes after aortic valve replacement for aortic insufficiency. METHODS: All consecutive adult patients who underwent bioprosthetic aortic valve replacement for aortic insufficiency at two European centres (in France and Germany) between May 2005 and December 2020 were analysed. RESULTS: During the study period, 289 patients were included. Mean age was 56.9±12.5 years. Overall operative mortality was 1.5%, and the 10-year survival estimate rate was 75.0%, which was significantly lower than in the age- and sex-matched general population, with a standardized mortality ratio of 2.88 (95% confidence interval 1.96-4.08; P<0001). Freedom from aortic valve-related death was 87.6%, and from aortic valve-related reoperation was 87.4%. No patient aged>60 years was reoperated on during follow-up. Freedom from severe structural valve deterioration at 10 years was 73.3%, and freedom from moderate structural valve deterioration at 10 years was 50.3%. Freedom from major adverse valve-related events at 10 years was 69.7%. CONCLUSIONS: Although bioprosthetic aortic valve replacement for aortic insufficiency shows good early results, 10-year mortality and major adverse valve-related event rates in young patients may be a concern, with a reduction in life expectancy compared with the general population.
Subject(s)
Aortic Valve Insufficiency , Aortic Valve Stenosis , Bioprosthesis , Heart Valve Prosthesis Implantation , Heart Valve Prosthesis , Adult , Humans , Middle Aged , Aged , Aortic Valve/diagnostic imaging , Aortic Valve/surgery , Retrospective Studies , Postoperative Complications , Heart Valve Prosthesis/adverse effects , Aortic Valve Insufficiency/diagnostic imaging , Aortic Valve Insufficiency/surgery , Aortic Valve Insufficiency/etiology , Aortic Valve Stenosis/surgery , ReoperationSubject(s)
Aortic Aneurysm, Thoracic/diagnostic imaging , Aortic Dissection/diagnostic imaging , Hematoma/diagnostic imaging , Tomography, Optical Coherence/methods , Acute Disease , Adult , Aortic Dissection/complications , Aortic Dissection/surgery , Aortic Aneurysm, Thoracic/complications , Aortic Aneurysm, Thoracic/surgery , Cardiac Surgical Procedures/methods , Fatal Outcome , Female , Hematoma/surgery , Humans , Postoperative Complications/physiopathology , ST Elevation Myocardial Infarction/diagnosis , ST Elevation Myocardial Infarction/etiology , Shock, Cardiogenic/diagnosis , Shock, Cardiogenic/etiologyABSTRACT
We report a case of left main coronary artery thrombosis 7 days after aortic valve replacement for native aortic valve regurgitation. The patient had undergone apicoaortic conduit implantation 3 years earlier. The thrombosis resulted from deviation of the cardiac output through the apicoaortic conduit and consequent turbulence of flow in the ascending aorta. Despite thrombus aspiration from the left main coronary artery, the patient never recovered and died 2 days later from multiple organ failure.