Aortic Valve Repair Results in Better One-Year Survival Than Replacement: Results From German Aortic Valve Registry

In this study, the authors aimed to analyze the one-year outcome after aortic valve (AV) repair versus surgical AV replacement (SAVR) in patients with aortic regurgitation (AR) using data from the German Aortic Valve Registry (GARY). A total of 8,076 AR patients were included in the analysis. The AV was repaired in 2,327 patients (29 percent) and 5,749 patients (71 percent) underwent SAVR. Patients were matched to correct for baseline differences in both study groups. After adjusting for baseline differences, the one-year survival rate was 97.7 percent (95 percent CI, 97.0 percent to 98.5 percent) in the AV repair cohort versus 96.4 percent (95 percent CI, 95.9 percent to 96.9 percent) SAVR cohort (log-rank P < 0.001). Cox regression analysis showed a significant age independent advantage of AV repair compared with SAVR (hazard ratio, 0.68; 95 percent CI, 0.51-0.90; P < 0.0001) on one-year survival. Furthermore, cardiac event-free survival at one year was 85.7 percent (95 percent CI, 483.8 percent to 87.7 percent) in the AV repair group versus 81.7 percent (95 percent CI, 80.7 percent to 82.9 percent) in the SAVR group (log-rank P < 0.001). There was no difference in the need for AV reintervention when comparing both the AV repair and SAVR cohorts (P = 0.59). The authors concluded that AV repair surgery, if technically feasible, is associated with higher superior one-year survival and one-year cardiac event-free survival than SAVR.