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The valve is excised 4–5 mm from the annulus, leaving intact the attached chordae unless they are calcified or otherwise diseased. The valve is replaced by a mechanical or bioprosthetic valve. The replacement valve is sewn into the annulus with interrupted or horizontal mattress sutures with the pledgets on the atrial side. [17]
Repair is a more recent alternative to replacement; in many instances replacement will be the only realistic option because of severe destruction of the valve. [ 6 ] While replacement of the aortic valve is a safe and reproducible procedure it may still be associated with the long-term occurrence of so-called valve-related complications.
Aortic valve replacement is a cardiac surgery procedure whereby a failing aortic valve is replaced with an artificial heart valve. The aortic valve may need to be replaced because of aortic regurgitation (back flow), or if the valve is narrowed by stenosis .
Tissue valves are less durable than mechanical valves, typically lasting 10–20 years. [20] This means that people with bioprosthetic valves have a higher incidence of requiring another aortic valve replacement in their lifetime. [16] Bioprosthetic valves tend to deteriorate more quickly in younger patients. [21]
There are two surgical options for the treatment of MR: mitral valve replacement and mitral valve repair. [6] Mitral valve repair is preferred to mitral valve replacement where a repair is feasible as bioprosthetic replacement valves have a limited lifespan of 10 to 15 years, whereas synthetic replacement valves require ongoing use of blood ...
The rationale for age-based recommendations is that surgical aortic valve replacements are known to be durable long-term (average of durability of 20 years), so people with longer life expectancy would be at higher risk if TAVI durability is worse than surgery. [9]
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