title: Risk of valve-related events after aortic valve repair.
abstract: BACKGROUND
  The impetus for aortic valve (AV) repair is to decrease valve-related complications in comparison to prosthetic valve replacement. However, relatively few data are available to confirm this hypothesis. We analyzed valve-related complications in a large series of patients undergoing AV repair.
  
  
  METHODS
  Between 1995 and 2010, 475 patients underwent elective AV repair for aortic insufficiency or aortic aneurysm. The mean age was 53 years, and 81% were male. Valve-related outcomes were defined as per published guidelines. Survival and freedom from valve-related events were reported using the Kaplan-Meier method and linearized event rates. Clinical follow-up was 98.3% complete with a mean follow-up time of 4.6 years.
  
  
  RESULTS
  Thirty-day mortality was 0.8% (n = 4). At 10 years, overall survival was 73% ± 5%, freedom from cardiac death was 81% ± 4%, and freedom from valve-related death was 90% ± 3%. Freedom from significant aortic insufficiency was 84% ± 3%. A total of 28 patients needed early (n = 7) or late (n = 21) AV reoperation; all of them survived reoperation, and 8 had repeat repair. Ten-year freedom from AV reoperation was 86% ± 3%, and freedom from AV replacement was 90% ± 3%. Freedom from AV reoperation was similar in tricuspid and bicuspid valve. During the follow-up period, linearized rate of thromboembolic event, bleeding, and AV endocarditis was 1.1%, 0.23%, and 0.19% per year, respectively. Ten-year freedom from valve-related events including AV reoperation, thromboembolic event, bleeding, and endocarditis was 74% ± 3%.
  
  
  CONCLUSIONS
  The current findings confirm that AV repair is associated with low mortality, acceptable durability, and a low risk of valve-related events.
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Cliniques Universitaires Saint-Luc, Univérsite Catholique de Louvain, Brussels, Belgium. dr.joel.price@gmail.com
authors.forename: Joel
authors.initials: J
authors.lastname: Price
authors.forename: Laurent
authors.initials: L
authors.lastname: De Kerchove
authors.forename: David
authors.initials: D
authors.lastname: Glineur
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vanoverschelde
authors.forename: Philippe
authors.initials: P
authors.lastname: Noirhomme
authors.forename: Gebrine
authors.initials: G
authors.lastname: El Khoury
mesh_terms: D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors