Current status of aortic valve-preserving surgery

However, AVP is a less common procedure than mitral valvuloplasty (MVP) at the general community level. With regard to aortic valve procedures for AR, AVP was performed in only 1.7% of cases in Europe in 20019 and 8% of cases in Japan in 201410. A literature search for only aortic root procedures indicated that VSRR had been performed in 14% of cases in the USA from 2004 to early 2010 (the Society of Thoracic Surgeons database study)11 and 34% in Japan in 2014 (our original nationwide questionnaire)10. According to the Japan Cardiovascular Surgery Database, the ratio of VSRR among elective aortic root procedures performed for non-redo cases of AR in Japan increased to 45% in 201712. Surprisingly, the in-hospital mortality rate after VSRR was only 0.7%, whereas it increased to 2.8% after composite valve graft replacement (even among matched groups, the rates were 0.8% and 1.8%, respectively)12. So, Japanese surgeons may be not only aggressive but also have the excellent outcomes in VSRR.