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).