Long term outcomes
Clinical and echocardiographic follow-up was 100% complete (mean
follow-up: 7.4±3.9 years, max 16.4; median 6.8 years [4.5-10.8]).
During the follow-up 2 patients died for non-cardiac causes whereas no
cardiac deaths occurred. Overall survival at 12 years was 97.4±2.5%,
95% CI [83.16-99.63] (Fig. 1). Aortic root surgery was not
necessary in any patient. Three patients underwent aortic valve
replacement. One patient needed reoperation for endocarditis 149 months
after the intervention. The others two patients developed severe aortic
valve stenosis: one underwent surgical AVR after 154 months, and the
other to transcatheter aortic valve implantation (TAVI), after 84
months. Interestingly, both patients didn’t show any grade of aortic
stenosis at the preoperative echocardiography in which only some degree
of regurgitation had been detected. None of the 3 patients with moderate
aortic stenosis at baseline did require aortic valve replacement for
significant disease progression. At 12 years the CIF of reoperation with
death as competing risk was 2.6 ±2.5%, 95% CI [0.20-11.53] (Fig.
2). At the echocardiographic follow up the median EF was 55 [55-60],
aortic regurgitation 3+/4+ was present in 1 patient and aortic stenosis
greater than moderate in 3 (Fig. 3,4). At 12 years the CIF of aortic
regurgitation >2+/4+ was 5.1±4.98% and of aortic stenosis
>moderate 6.9±3.8% (Fig. 5).