Follow-up results
Table 3 lists the follow-up data. The median follow-up time was 5.6 years [2.0; 9.1], and 45 (88.2%) patients having follow-up TTE data within the last 2 years. Two patients were considered lost to follow-up because they have had no medical consultation for more than 10 years.
The 5-year overall survival was 90.9% (95% CI, 74.3%–97.0%), and the 10-year overall survival was 84.9% (95% CI, 62.4%–94.4%). Four (7.8%) patients died during the follow-up period, three following stroke and one from drowning. The strokes, one of them hemorrhagic and the other two of unknown etiology, occurred more than 3 years after the surgery (3.5, 3.9 and 8.9 years after, respectively), and the mean age at death was 58.8±4.5 years. Rehospitalization was reported for 18 patients, 7 of them (13.7%) for cardiac events: two with endocarditis necessitating Bentall’s procedure with mechanical prosthesis at 15 months and 93 months, respectively, and one with mitral insufficiency at 4.5 years after the Tirone procedure. For this last patient, echocardiography showed a modified aortic valve associated with stenosis, so reoperation consisted of a double biological replacement valve. Two patients had been treated for atrial fibrillation, and two others had a pacemaker implanted well after the surgery. There were no deaths with reinterventions.
Regarding medical outcomes, 45 patients had not had discomfort since surgery and three had New York Heart Association (NYHA) II dyspnea. Three others patients (5.9%) needed an anticoagulant drug, while six (11.8%) were without medication. The reports were all from recent follow-up, with less than one year since Canadian Cardiovascular Society and NYHA classification, and less than 2 years for transesophageal echography TEE-related data and events since surgery. The follow-up TEE data showed ejection fraction at 62.6±6.7% (n=36) and a Vmax 2.0±0.6 m/s (n=17), a mean gradient of 9.4±5.4 mmHg (n=27), and no grade III or IV aortic regurgitation (Table 3).