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Systematic review of aortic valve preservation versus replacement for insufficiency and aortic root aneurysm
Dissertation   Open access

Systematic review of aortic valve preservation versus replacement for insufficiency and aortic root aneurysm

Melanie Freas
Doctor of Nursing Practice (D.N.P.), Drexel University
2018
DOI:
https://doi.org/10.17918/xxwc-g983
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Abstract

Nursing--Practice Aortic valve--Surgery Aortic valve insufficiency Aortic aneurysms Nursing
Objective: To examine the current published literature on the outcomes and durability of aortic valve preservation with repair or valve sparing procedures (AVS) when compared to aortic valve replacement (AVR) for aortic valve insufficiency in the setting of aortic root enlargement. Method: Following an extensive search of the literature, studies were selected using the established inclusion and exclusion criteria. Fourteen studies were selected to undergo systematic review. Population characteristics, and surgical procedures were examined. Residual aortic insufficiency and freedom from reoperation were examined within the first thirty-days of surgery. Durability of the valve was quantified by the amount of residual aortic insufficiency and freedom from reoperation at one year and five year follow ups. Conclusion: Based on the articles reviewed, when appropriate, AVS is an acceptable alternative for surgical intervention for aortic insufficiency and aortic root enlargement. Both AVS and AVR procedures showed less then +2-grade residual aortic insufficiency at the 30-day follow-up. However, within one year, AVS demonstrated a return to preoperative grade +3 and +4 aortic insuffiencey. To provide evidence-based information when discussing aortic valve surgeries, continued research is essential into the longevity and durability of the AVS procedure.

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