New Insights into the Treatment of Aortic Valve Disease

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 30 July 2024 | Viewed by 1118

Special Issue Editors


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Guest Editor
Department of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, Cologne, Germany
Interests: valve surgery; aortic valve replacement; biological aortic valve; mechanical aortic valve; rapid-deployment valve (RDV); transcatheter aortic valve replacement (TAVR); endocarditis; anticoagulation strategies new oral anticoagulants (NOACs)

E-Mail Website
Guest Editor
Department of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, Cologne, Germany
Interests: valve surgery; aortic valve replacement; biological aortic valve; mechanical aortic valve; rapid-deployment valve (RDV); transcatheter aortic valve replacement (TAVR); endocarditis; anticoagulation strategies new oral anticoagulants (NOACs)

E-Mail Website
Guest Editor
Department of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, Cologne, Germany
Interests: heart failure; cardiac surgery; cardiovascular surgery
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Special Issue Information

Dear Colleagues,

Patients undergoing aortic valve surgery can undergo open heart surgery with valve replacement or transcatheter aortic valve implantation. Besides the choice of the type of intervention, the most suitable aortic valve prosthesis also has to be identified. Since there has been tremendous change in the landscape of aortic valve surgery in recent decades, the choice between mechanical aortic valves and aortic bioprosthesis has shifted. Even if mechanical heart valves show superior long-term durability, lifelong anticoagulation with an elevated risk for bleeding events is mandatory. As oral anticoagulation medication is generally not necessary after the implantation of a biological heart valve prosthesis, this type of valve is limited by structural valve deterioration and its duration. Rapid-deployment valves could be considered as an alternative to conventional biological artic prosthesis as they might be easier and faster to implant via a minimally invasive surgery access site. The design of rapid-deployment valves can be compared to transcatheter aortic valves, which are mostly implanted via a femoral vessel access point. Transcatheter aortic valve procedures emerged from a procedure for patients with a very high perioperative risk and represent an alternative to conventional aortic valve replacement for selected patients. Besides the extension of treatment options for patients with an aortic valve defect, the patient collective is becoming more and more complex, driven by rising numbers of re-operations and endocarditis.

This Special Issue, entitled “New Insights into the Treatment of Aortic valve Disease”, aims to critically discuss the clinical advantages and disadvantages of current options in aortic valve surgery.

Dr. Stephen Gerfer
Dr. Kaveh Eghbalzadeh
Dr. Ilija Djordjevic
Guest Editors

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Keywords

  • aortic stenosis
  • aortic insufficiency
  • endocarditis
  • aortic valve surgery
  • aortic root surgery
  • open heart surgery
  • minimally invasive heart surgery
  • transcatheter–aortic valve implantation (TAVI/TAVR)
  • biological valve replacement
  • mechanical valve replacement
  • rapid-deployment aortic valve replacement (RDV)
  • oral anticoagulation

Published Papers (1 paper)

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Research

14 pages, 1387 KiB  
Article
Impact of Aortic Root Abscess on Surgical Outcomes of Infective Endocarditis
by Ahmed Elderia, Anna-Maria Wallau, Walid Bennour, Stephen Gerfer, Christopher Gaisendrees, Ihor Krasivskyi, Ilija Djordjevic, Thorsten Wahlers and Carolyn Weber
Life 2024, 14(1), 92; https://doi.org/10.3390/life14010092 - 7 Jan 2024
Viewed by 791
Abstract
Locally destructive infective endocarditis (IE) of the aortic valve complicated by abscess formation in the aortic root may seriously affect patients’ outcomes. Surgical repair of such conditions is often challenging. This is a single-center observational analysis of consecutive patients treated surgically for IE [...] Read more.
Locally destructive infective endocarditis (IE) of the aortic valve complicated by abscess formation in the aortic root may seriously affect patients’ outcomes. Surgical repair of such conditions is often challenging. This is a single-center observational analysis of consecutive patients treated surgically for IE between 2009 and 2019. We divided the cohort into two groups considering the presence of an aortic root abscess and compared the characteristics and postoperative outcomes of patients accordingly. Moreover, we examined three different procedures performed in abscess patients regarding operative data and postoperative results: an isolated surgical aortic valve replacement (AVR), AVR with patch reconstruction of the aortic root (AVR + RR) or the Bentall procedure. The whole cohort comprised 665 patients, including 140 (21.0%) patients with an aortic root abscess and 525 (78.9%) as the control group. The abscess group of patients received either AVR (66.4%), AVR + RR (17.8%), or the Bentall procedure (15.7%). The mean age in the whole cohort was 62.1 ± 14.8. The mean EuroSCORE II was 8.0 ± 3.5 in the abscess group and 8.4 ± 3.7 in the control group (p = 0.259). The 30-day and 1-year mortality rates were 19.6% vs. 11.3% (p = 0.009) and 40.1% vs. 29.6% (p = 0.016) in the abscess compared to the control group. The multivariable regression analysis did not reveal aortic root abscess as an independent predictor of mortality. Rather, age > 60 correlated with 30-day mortality and infection with Streptococcus spp. correlated with 1-year mortality. In the analysis according to the performed procedures, KM estimates exhibited comparable long-term survival (log-rank p = 0.325). IE recurrence was noticed in 12.3% of patients after AVR, 26.7% after AVR + RR and none after Bentall (p = 0.069). We concluded that patients with an aortic root abscess suffer worse short and long-term outcomes compared to other IE patients. The post-procedural survival among ARA patients did not significantly vary based on the procedures performed. Full article
(This article belongs to the Special Issue New Insights into the Treatment of Aortic Valve Disease)
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