Advances in Aortic Valve Repair and Aortic Valve Replacement

Dear Colleagues,

The increasing prevalence of patients with significant aortic valve disease requiring treatment world-wide luckily coincides with exciting advances in the available therapeutic options. Transcatheter techniques in one such field have provided a viable option for elderly and high risk patients with aortic valve stenosis. With the refinement of available bio-prosthetic valves and technical details of implantation, these techniques attempt to shift the treatment paradigm from surgery to TAVI, even in younger and lower-risk patients. Data are anticipated to support or refute this goal. On the other aspect, the surgical approach continues to offer proven, long-term results in younger patients receiving a mechanical prosthesis or ‘older’ but not too old patients receiving equally evolving bioprosthetic valves, such as sutureless and zero-glutaraldeyde fixation, valves with improved durability, and the remarkable track record of SVD. Newer technology polymer valves that may combine the best of both (mechanical vs. bio prosthetic) types are eagerly anticipated. Fascinating techniques like the Osaki, in combination with evolving AI-assisted bio printing, may offer an attractive alternative for these group of patients with isolated aortic valve stenosis. On another aspect, in aortic valve regurgitation with or without annular aortopathy, surgery remains the golden standard, with an array of therapeutic options ranging from the well-established aortic root replacement with composite valved graft (Kouchoukos) to more refined aortic-valve-sparing techniques, such as the David IV and modifications. Furthermore, literature is being generated regarding isolated valve repair techniques where long-term results require validation. All these treatment options are being led by the overwhelming demand for the minimization of invasiveness. The surgical community, in keeping with this shifting paradigm, embraces available technologies, making minimally-invasive aortic valve surgery a more common approach to the all-time classic, median sternotomy, and even offering, in high volume valve centers, endoscopic aortic valve replacement and repair.

Through contributions from leading experts on aortic valve treatment, the present edition provides an updated view on the current state of the art and offers valuable insight into the future direction of this field.

Dr. Konstantinos G. Perreas
Guest Editor

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• valvular heart disease
• aortic valve stenosis
• aortic valve regurgitation
• bicuspid aortic valve
• minimally invasive surgery
• surgical aortic valve replacement
• transcatheter aortic valve replacement
• aortic valve prosthesis
• transcatheter devices
• long-term outcomes