Early Valve Replacement for Severe Aortic Valve Disease: Effect on Mortality and Clinical Ramifications

Jason P. Koerber, Jayme S. Bennetts, Peter J. Psaltis

Research output: Contribution to journalReview articlepeer-review

4 Citations (Scopus)
1 Downloads (Pure)

Abstract

Timing of aortic valve intervention for chronic aortic regurgitation (AR) and/or aortic stenosis (AS) potentially affects long-term survival. The 2014 American Heart Association/American College of Cardiology (AHA/ACC) guidelines provide recommendations for the timing of intervention. Subsequent to the guidelines’ release, several studies have been published that suggest a survival benefit from earlier timing of surgery for severe AR and/or AS. The aim of this review was to determine whether patients who have chronic aortic regurgitation (AR) and/or aortic stenosis (AS) have a survival benefit from earlier timing of aortic valve surgery. Medical databases were systematically searched from January 2015 to April 2020 for randomized controlled trials (RCTs) and observational studies that examined the timing of aortic valve replacement surgery for chronic AR and/or AS. For chronic AR, four observational studies and no RCTs were identified. For chronic AS, five observational studies, one RCT and one meta-analysis were identified. One observational study examining mixed aortic valve disease (MAVD) was identified. All of these studies, for AR, AS, and MAVD, found long-term survival benefit from timing of aortic valve surgery earlier than the current guidelines. Larger prospective RCTs are required to evaluate the benefit of earlier surgical intervention.

Original languageEnglish
Article number2694
Number of pages20
JournalJournal of Clinical Medicine
Volume9
Issue number9
Early online date20 Aug 2020
DOIs
Publication statusPublished - Sep 2020

Keywords

  • Aortic regurgitation
  • Aortic stenosis
  • Aortic valve replacement
  • Mixed aortic valve disease
  • Survival
  • Transcatheter aortic valve implantation
  • Valvular heart disease

Fingerprint

Dive into the research topics of 'Early Valve Replacement for Severe Aortic Valve Disease: Effect on Mortality and Clinical Ramifications'. Together they form a unique fingerprint.

Cite this