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Why I choose to repair and not to replace the aortic valve?

  • SPECIAL EDITION
  • Controversies in Surgery for Thoracic Aorta
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Abstract

Aortic valve replacement whether surgical or transcutaneous remains an option for the treatment of severe aortic valve disease; however, current prosthetic devices are associated with complications including, but no limited to, valve thrombosis and thromboembolic events, bleeding events associated with anticoagulation use, prosthetic valve endocarditis and structural valve deterioration. In this effect, aortic valve repair (AVr) has become an attractive alternative in circumventing these potential complications by preservation of the native aortic valve apparatus. In this article, we attempt to present the progress made for AVr over the last two decades. We also wish to highlight the critical steps for successful AVr and the outcome data that demonstrate that can be first-choice treatment in selected patients and finally to emphasize on the key steps for further future development.

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Abbreviations

AV:

Aortic valve

AVr:

Aortic valve repair

AI:

Aortic insufficiency

COR:

Class of recommendation

LOE:

Level of evidence

LVEF:

Left ventricular ejection fraction

LVESD:

Left ventricular end systolic dimension

LVEDD:

Left ventricular end diastolic dimension

AVJ:

Aortoventricular junction

STJ:

Sinotubular junction

MV:

Mitral valve

FAA:

Functional aortic annulus

CVG:

Composite valve graft

TAVI:

Transcatheter aortic valve implantation

SCA:

Subcommissural annuloplasty

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Authors and Affiliations

  1. Department of Cardiac Surgery, Barts Heart Centre, St Bartholomew’s Hospital, London, UK

    Athanasios Antoniou, Amer Harky & Mohamad Bashir

  2. School of Medicine, Cardiff University, Cardiff, UK

    Amer Harky

  3. Department of Cardiovascular and Thoracic Surgery, St Luc’s Hospital, Catholic University of Louvain, Brussels, Belgium

    Gebrine El Khoury

Authors
  1. Athanasios Antoniou
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  2. Amer Harky
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  3. Mohamad Bashir
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  4. Gebrine El Khoury
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Correspondence to Mohamad Bashir.

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Antoniou, A., Harky, A., Bashir, M. et al. Why I choose to repair and not to replace the aortic valve?. Gen Thorac Cardiovasc Surg 67, 20–24 (2019). https://doi.org/10.1007/s11748-018-0920-3

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  • DOI: https://doi.org/10.1007/s11748-018-0920-3

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