Closing remarks
In summary, the clinical course of patients with AR is suboptimal. AVP
has attracted a great deal of attention as both mechanical and
biological AVR have major disadvantages. Nonetheless, AVP has not been
widely adopted due to the complexity of its technique and assessment.
Due to recent technical and theoretical advances, AVP is anticipated to
be increasingly performed with better outcomes. A number of prospective
multicenter studies, such as CAVIAAR45,
AVIATOR27, and Japanese Registry (UMIN000016145), are
currently underway and will clarify the actual role of AVP in surgical
treatment of AR in the near future.