Aortic Valve Surgery in Nonelderly Patients: Insights Gained From AVIATOR

Autor: Jean-François Fuzellier, Christophe de Meester, Rémi Houel, Florence Tubach, Georges Fayad, Maciej Matuszewski, Eric Arnaud-Crozat, Svenja Rauch, Jean-François Obadia, Adrian Kolesar, Matteo Pettinari, Bardia Arabkhani, Jos A. Bekkers, Fabrizio Ceresa, Andrea Mangini, Dave R. Koolbergen, Daniel Czytrom, František Sabol, Thomas J van Brakel, Ignacio Bibiloni, Pallav Shah, Rosina Ziller, Alain Leguerrier, Marek Jasiński, Gianclaudio Mecozzi, Mihail Svetkin, Taoufik Benkacem, Jaroslav Hlubocky, Hans-Joachim Schäfers, Vincent Doisy, Jean-Luc Monin, Christine Leon, Carlo Antona, Jan Vojacek, Munir Boodhwani, Francesco Patane, Andrey Slautin, Gebrine Elkhoury, Rubina Rosa, Yutaka Okita, Ismail El-Hamamsy, Wenke Goossens, Alain Berrebi, Paolo Ferrero, Jan Nijs, Fabien Doguet, Mauro Masat, Monica Contino, Edward P. Chen, Gregorio Rábago, Stéphane Lopez, Duke E. Cameron, Johannes Steindl, José Aramendi, Eric Bergoend, Maurice Enriquez-Sarano, Jean-Louis Vanoverschelde, Bart Meuris, Virginia Alvarez-Asiain, Robert Novotny, Davor Barić, Michael A. Borger, Tomas Toporcer, Ruggero De Paulis, Leila Mankoubi, J. M. Marnette, Christelle Diakov, Amaia Melero, Said Soliman, Michael Tousch, Ryan E. Accord, Philippe Pibarot, Mikita Karalko, Vladislav Aminov, Agnes Pasquet, Serban Stoica, David Messika Zeitoun, Olivier Bouchot, Bernard Albat, Jérôme Jouan, Savica Gjorgijevska, Klaartje Van den Bossche, Igor Rudez, J. Kluin, Laurent de Guillaume Jondeau, Didier Chatel, Pascal Leprince, Sarah Pousset, Rafael Sadaba, Veerle Van Mossevelde, Evi Schepmans, Johanna J.M. Takkenberg, Carlos Porras, Herbert Gutermann, Isabelle Di Centa, Aude Boignard, Joseph E. Bavaria, Pierre-Emmanuel Noly, Yves Glock, Corinne Coulon, Bart Loeys, Rita K. Milewski, Christian Dinges, Marien Lenoir, Francesco Grigioni, Alejandro Crespo, Patrick Moeller, Frederiek de Heer, Mohamad Bashir, Milean Noghin, Fadoua Kaddouri, Takashi Kunihara, Isaac Wenger, Ilaria Chirichilli, Claudia Romagnoni, Diana Aicher, Arturo Evangelista Masip, Daniel Unić, Emmanuel Lansac, Fabrice Wautot, Peter Verbrugghe, Laurent de Kerchove, Pouya Youssefi, Josip Varvodić, Robert J.M. Klautz, Patrick Yiu, Frank Theisohn, Pavel Zacek, Guy Fernandez, Takeshi Miyairi, Thierry Bourguignon
Přispěvatelé: Cardiothoracic Surgery, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, UCL - (SLuc) Service de chirurgie cardiovasculaire et thoracique
Rok vydání: 2019
Předmět:
Aortic valve
Time Factors
Nonelderly patients
medicine.medical_treatment
Heart Valve Diseases
AVIATOR
Aortic valve surgery
Adult
Age Factors
Aortic Valve
Bioprosthesis
Evidence-Based Medicine
Heart Valve Prosthesis
Life Expectancy
Middle Aged
Prosthesis Failure
Recovery of Function
Registries
Risk Factors
Treatment Outcome
Heart Valve Prosthesis Implantation
Transcatheter Aortic Valve Replacement
030204 cardiovascular system & hematology
0302 clinical medicine
Aortic valve repair
Quality of life
Expectancy theory
education.field_of_study
Ross procedure
General Medicine
medicine.anatomical_structure
Cardiology and Cardiovascular Medicine
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Population
03 medical and health sciences
medicine
Humans
education
business.industry
Mechanical Aortic Valve
Surgery
Settore MED/23
030228 respiratory system
Life expectancy
business
Zdroj: Seminars in Thoracic and Cardiovascular Surgery, 31(4), 643-649. W.B. Saunders
Seminars in thoracic and cardiovascular surgery, Vol. 31, no.4, p. 643-649 (2021)
ISSN: 1043-0679
Popis: Aortic valve surgery in non-elderly patients represents a very challenging patient population. The younger the patient is at the point of aortic valve intervention, the longer their anticipated life expectancy will be, with longer exposure to valve-related complications and risk for re-operation. Although the latest international guidelines recommend aortic valve repair in patients with aortic valve insufficiency, what we see in the real world is that the vast majority of these aortic valves are replaced. However, current prosthetic valves has now been shown to lead to significant loss of life expectancy for non-elderly patients up to 50% for patients in their 40s undergoing mechanical aortic valve replacement. Bioprostheses carry an even worse long-term survival, with higher rates of re-intervention. The promise of trans-catheter valve-in-valve technology is accentuating the trend of bioprosthetic implantation in younger patients, without yet the appropriate evidence. In contrast, aortic valve repair has shown excellent outcomes in terms of quality of life, freedom from re-operation and freedom from major adverse valve-related events with similar life expectancy to general population as it is also found for the Ross procedure, the only available living valve substitute. We are at a time when the paradigm of aortic valve surgery needs to change for the better. To better serve our patients, we must acquire high quality real-world evidence from multiple centers globally - this is the vision of the AVIATOR registry and our common responsibility.
Databáze: OpenAIRE
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