Baseline characteristics
Table 1 summarizes the baseline characteristics of our patients. From January 2018 to June 2020 we operated 40 patients. Two who were directly converted to prosthetic valve replacement in the operating room due to moderate-severe AV insufficiency were excluded. In 2020 and 2021 our AVRec surgery program was stopped due to the covid-19 pandemic.
For the analysis we included 38 patients, the median age was 62 years (IQR 25), and the proportion according to sex was 50/50. Twenty patients (52,7%) were overweight or obese before surgery. We did not include patients in cardiogenic shock or functional class IV.
The main indication for surgery was AV stenosis (63.1%) in most cases due to bicuspid valve (19 patients, 50%). Something to highlight is that in two patients we performed this procedure in redo-surgeries (prosthesis dysfunction, one with a biological and the other with mechanic prosthesis). It was possible to carefully remove the autologous pericardium in these patients.
The median size of the AV annulus was 23 (IQR 5), however we operated 13 patients (34.2%) with small AV annulus (<21mm). The medians of the peak and mean AV gradient were 73mmHg (IQR 78) and 46mmHg (IQR 48), respectively. When we only include patients with AV stenosis gradients were 89 mmHg (IQR 25) and 55mmHg (IQR 17), respectively.
Twenty-two (58%) patients had another associated pathology with surgical indication in addition to AV disease, 8(21%) of them had dilatation of the ascending aorta with indication for replacement. 21% (8 patients) used oral anticoagulants (OAC) as a treatment for chronic atrial fibrillation (AF).