Aortic valve repair in a middle-income country: Exceptional outcomes and mid-term results

Abstract

Objective

Aortic valve repair has proven to be a low-risk perioperative procedure, with favorable mid-term outcomes and additional benefits linked to the avoidance of prosthetic valves, including freedom from anticoagulation and reintervention, reduced risk of endocarditis, and thromboembolic complications. Furthermore, an aortic valve repair program in Colombia confers potential advantages specific to our population, considering the sociodemographic factors of middle-income countries.

Methods

A retrospective analysis was conducted on the clinical and perioperative results, as well as mid-term follow-up data of patients who underwent aortic valve repair surgery at 2 Colombian health institutions between March 2018 and December 2023.

Results

A total of 104 patients were treated, with a mean age of 57 years, of whom 82.7% were male. In all cases, the preoperative diagnosis was aortic regurgitation, with 75% exhibiting aortic root or ascending aorta dilation. The median cardiopulmonary bypass and aortic crossclamp times were 140 minutes and 116 minutes, respectively. The 30-day mortality was 1.9%. Follow-up was completed in 95.1% of cases, with survival at 1, 3, and 5 years of 97%, 94.3%, and 90.9%, respectively. Freedom from reintervention and freedom from anticoagulation at 1, 3, and 5 years were 98.6%, 98.6%, and 95.3%, and 84.9%, 77.9%, and 77.9%, respectively.

Conclusions

In our study, aortic valve repair emerged as an effective and durable procedure, offering benefits that could be particularly relevant in middle-income countries. Perioperative and follow-up outcomes were comparable to those reported in large series in the literature.