Longitudinal Changes in Exercise Capacity in Patients Who Underwent Ross Procedure and Mechanical Aortic Valve Replacement: Does the Type of Surgery Matter?

Physical and Mental Recovery after Aortic Valve Surgery in Non-Elderly Patients: Native Valve-Preserving Surgery vs. Prosthetic Valve Replacement

“…Only peak VO 2 and work rate were considerably better in NV patients than in PV patients 1 year postoperatively, which is in agreement with a recently published study that reported better initial postoperative exercise capacity assessed with cardiopulmonary exercise testing in children and young adults after the Ross procedure than after mechanical AVR at the mid-term follow-up [13]. However, it must be pointed out that the observed between-group differences in our patients were already present at baseline and were potentially linked to differences in age and sex distribution in both groups.…”

“…Yet, currently, no firm evidence confirming the believed superiority of native valve-preserving procedures over conventional prosthetic AVR exists, and the advantages of native valve preservation in terms of postoperative outcome determinants other than morbidity and mortality (e.g., postoperative recovery of exercise capacity as well as patient-reported outcomes) still have to be defined. Currently, only few retrospective, cross-sectional reports investigating differences in either exercise capacity [13] or patient-reported outcomes [14][15][16][17] among AV repair, Ross procedure and prosthetic AVR are available. Moreover, only two prospective studies evaluated longitudinal changes in exercise capacity alone [18] or combined with mental well-being [19] following AV surgery but without differentiating among surgical techniques.…”

“…According to the hierarchical test procedure, no further ATT testing was performed with respect to physical and mental QoL. According to Figures 2 and 3, it can, however, be deduced that physical and mental QoL scores were similar in both groups at the 1-year follow-up (median physical QoL score, 55 (6) in NV vs. 54 (7) in PV patients; median mental QoL score, 56 (7) in NV vs. 56 (13) in PV patients). This average treatment effect on the treated group was positive, but not significant (95% CI: −17.03-88.30; adj.…”