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.