The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Comparative StudyLong-term prognosis of ascending aortic aneurysm after aortic valve replacement for bicuspid versus tricuspid aortic valve stenosis.
The bicuspid aorta is thought to have a higher risk of progressive dilation after aortic valve replacement with a subsequently increased risk of adverse aortic events. Our aim was to compare the risk of late aortic events after isolated aortic valve replacement surgery for bicuspid versus tricuspid aortic valve stenosis with concomitant mild to moderate dilatation of the proximal aorta. ⋯ Patients with bicuspid and tricuspid aortic valve stenosis with concomitant mild to moderate ascending aortic dilatation are at comparably low risk of adverse aortic events 15 years after isolated aortic valve replacement.
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Comparative StudyMechanical versus bioprosthetic mitral valve replacement in patients <65 years old.
Because of its durability, the mechanical valve is typically chosen for young patients undergoing mitral valve replacement (MVR). However, a bioprosthetic valve might have the benefit of valve-in-valve transcatheter valve replacement when valve failure occurs. We examined the outcomes in patients who had undergone mechanical valve MVR (MVRm) versus bioprosthetic valve MVR (MVRb) in patients aged <65 years. ⋯ In the present report, MVRb for patients <65 years old was associated with a high reoperation rate and decreased survival. Although a future transcatheter valve-in-valve technique for a failed bioprosthetic valve might reduce the risk of reoperation, this finding confirms the safety of mechanical valves in this group.
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Expanding relevance of aortic valve repair-is earlier operation indicated?
To define the durability of aortic valve repair (AVRep) and the effect of surgical timing on late survival. ⋯ AVRep can be performed with excellent late survival and freedom from valve-related events. Awaiting the onset of ventricular dysfunction increases the risk of late mortality, warranting earlier consideration of AVRep for patients with suitable anatomy.