Aortic valve surgery in non-elderly people is a particularly difficult procedure. When the aortic valve is replaced, the younger the patient is, the longer their expected life expectancy will be, with a higher chance of valve-related problems and re-operation. Although the most recent worldwide guidelines urge aortic valve repair in patients with aortic valve insufficiency, the great majority of these aortic valves are replaced in the real world. On the other hand, current prosthetic valves have been found to cause a considerable loss of life expectancy in non-elderly patients, with persons in their 40s losing up to 50% of their life expectancy after mechanical aortic valve replacement. Bioprostheses have an even worse long-term survival rate, with higher re-intervention rates.
Despite a lack of proof, the promise of transcatheter valve-in-valve technology boosts the trend of bioprosthetic implantation in younger patients. Aortic valve repair, on the other hand, has demonstrated excellent results in terms of quality of life, freedom from re-operation, and freedom from major adverse valve-related events, with life expectancy comparable to the general population, as has also been found for the Ross procedure, the only available living valve substitute. Researchers are at a point when the aortic valve surgery paradigm must shift for the better. To better assist the patients, Researchers need to collect high-quality, real-world evidence from many locations worldwide — this is the AVIATOR registry’s vision and the shared obligation.
Reference:www.semthorcardiovascsurg.com/article/S1043-0679(19)30010-3/fulltext
