Abstract 3169: Contemporary Results of Isolated Aortic Valve Surgery
Objectives: After the introduction of the catheter-based methods of aortic valve implantation, we aimed to give an overview of the contemporary status-of-the-art of surgical aortic valve replacement.
Methods: This single-Institution prospective study was undertaken in January 2003. From this date on, each patient with aortic valve disease of any degree admitted to our hospital was reviewed by a cardiologist and a surgeon to determine eligibility. In no instance the operation was denied in absence of surgical consultation. All the operations were carried on by median sternotomy, cardiopulmonary bypass and cardioplegic arrest.
Results: Until the end of the study, 873 cases with severe aortic valvular disease were screened. Among these, we identified three groups of patients:
Inoperable cases: 15 patients (1%);
High-risk cases: 99 patients with additive EuroSCORE ≥10 or expected mortality >20% (logistic model);
Rest of the population: 759 patients. Operative mortality was 6.0% (6/99) for the High-risk group and 0.4% (3/759) for the Rest of the population.
Major complications occurred in 5 patients of the High-risk group (5%) and 9 patients of the Rest of the population (1.1%). At pre-discharge echocardiography, 99.3% of the implanted valves were perfect. At the end of the follow-up 798/849 patients were alive; 89% of them (711) were in good clinical and haemodynamic conditions (NYHA 1–2). Actuarial survival curves for the three subgroups are given in graphic.
Conclusion: Surgical aortic valve replacement affords excellent results and low operative mortality in high risk patients. Our data should be regarded as a benchmark for comparison for the transcatheter techniques.