Aortic valve replacement in non-elderly: the gap between reality, guidelines and evidence.
Eur J Cardiothorac Surg
; 64(5)2023 11 01.
Article
em En
| MEDLINE
| ID: mdl-37756688
ABSTRACT
OBJECTIVES:
There are several treatment options for non-elderly adults (18-60 years) in need of aortic valve replacement (AVR) a mechanical or biological substitute, a homograft, the Ross procedure or nowadays even transcatheter aortic valve replacement. This study evaluated the current opinions and practices of cardiac surgeons and cardiologists concerning AVR strategies in this patient group.METHODS:
A 43-item online survey was sent out to several scientific organizations, individual cardiac surgeons, cardiologists and residents/fellows worldwide.RESULTS:
Two hundred twenty-two physicians from 33 different countries answered the survey. The UK (24%), Belgium (23%) and North America (22%) are best represented. A mechanical valve is the most frequently used substitute in non-elderly. With increasing patient age, the popularity of a biological valve increases. Transcatheter aortic valve replacement and the Ross procedure are each used in <10% of this cohort. Only 12% of the cardiac surgeons has experience with the Ross surgery. In 23%, the patient seems not to be involved in the decision on the type of valve substitute.CONCLUSIONS:
The preferred surgical treatment for non-elderly patients in need of AVR differs widely. To enable a shared decision-making process including patient preferences, there is more need for collaboration between cardiac departments, as well as education and scientific research about patient-centred outcomes of the different AVR techniques.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Insuficiência da Valva Aórtica
/
Estenose da Valva Aórtica
/
Próteses Valvulares Cardíacas
/
Implante de Prótese de Valva Cardíaca
Tipo de estudo:
Guideline
Limite:
Adult
/
Humans
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Middle aged
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article