{
  "abstract": "Objective\n\nTo compare the long-term outcomes of aortic valve repair (AVr) (REPAIR group) with biological aortic valve replacement (bAVR group).Methods\n\nAdults who underwent REPAIR or bAVR for aortic regurgitation (AR) +/- ascending aortic aneurysm (AscAA), recorded in the Heart Valve Society database until April 2024, were included. Propensity score matching was used to adjust for confounders. Differences in long-term survival, major adverse valve-related events (MAVRE), and other valve-related events were assessed.Results\n\nIn total, 7318 patients were included (REPAIR n = 6773, bAVR n = 545). Propensity score matching resulted in 1006 REPAIR patients matched to 530 bAVR patients (median age: 67 years [interquartile range, 59.0-73.0], 22% female). In the matched cohort, early mortality (≤30 days) was comparable between REPAIR and bAVR patients (1.2% vs 2.1%, P = .070). At 7.5 years, overall matched survival was lower in the bAVR group compared to the REPAIR group (73.9% [95% CI, 66.5%-82.1%] vs 85.6% [95% CI, 82.3%-89.3%], P < .001), with a higher proportion of valve-related deaths (bAVR 4.2% vs REPAIR 1.2%, P < .001). At 7.5 years, patients with bAVR had significantly lower freedom from MAVRE (P < .001) and more infective endocarditis (P = .006), and severe valve dysfunction (P < .001) compared to patients with REPAIR. The incidences of aortic valve reintervention (P = .388) and pacemaker implantation (P = .671) were comparable.Conclusions\n\nAmong patients in whom repair was deemed feasible and surgery was performed at mainly expert centers, repair was associated with more favorable long-term outcomes, including improved survival, compared with bAVR in an older propensity-matched cohort. These findings support the consideration of AVr when technically feasible in patients with AR, with or without AscAA.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiovascular and Thoracic Surgery, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.",
    "Department of Cardiology, Erasmus University Medical Centre, Rotterdam, The Netherlands.",
    "Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands.",
    "Department of Cardiac Surgery, Montreal Heart Institute, Université de Montréal, Heart Institute, Montréal, Canada.",
    "Department of Cardiothoracic and Vascular Surgery, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium.",
    "Department of Cardiothoracic Surgery, IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milano, Italy.",
    "Department of Cardiovascular Sciences, Cardiac Surgery Unit, Leuven, Belgium."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Pichoy Danial"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Adine R de Keijzer"
    },
    {
      "affs": [
        2
      ],
      "name": "Johanna J M Takkenberg"
    },
    {
      "affs": [
        3
      ],
      "name": "Vincent Chauvette"
    },
    {
      "affs": [
        4
      ],
      "name": "Laurent de Kerchove"
    },
    {
      "affs": [
        2
      ],
      "name": "Jolanda Kluin"
    },
    {
      "affs": [
        5
      ],
      "name": "Claudia Romagnoni"
    },
    {
      "affs": [
        6
      ],
      "name": "Peter Verbrugghe"
    },
    {
      "affs": [
        0
      ],
      "name": "Pascal Leprince"
    },
    {
      "affs": [
        2
      ],
      "name": "Kevin M Veen"
    },
    {
      "affs": [
        0
      ],
      "name": "Emmanuel Lansac"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bsk25hrh51zp5.bib",
  "cited_by": 0,
  "doi": "10.1016/j.xjon.2026.102085",
  "fulltext_url": "https://europepmc.org/articles/PMC13711288",
  "id": "bsk25hrh51zp5",
  "issns": [
    "2666-2736"
  ],
  "landing_url": "https://europepmc.org/article/MED/42948464",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Adult: Aortic Valve"
    ],
    [
      "openalex",
      "2705|Cardiac Valve Diseases and Treatments"
    ]
  ],
  "openalex": "W7204230736",
  "pdf_url": "https://europepmc.org/articles/PMC13711288?pdf=render",
  "pmcid": "PMC13711288",
  "pmid": "42948464",
  "published": "2026-08-26",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/bsk25hrh51zp5.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:35Z",
      "native_id": "MED:42948464",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948464"
    },
    {
      "first_seen": "2026-10-31T12:22:05Z",
      "native_id": "PMC13711288",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.xjon.2026.102085"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Cardiac Valve Diseases and Treatments",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Aortic valve repair versus biological replacement for aortic regurgitation with or without ascending aortic aneurysm: Heart Valve Society Aortic Valve Database Study.",
  "title_text": "Aortic valve repair versus biological replacement for aortic regurgitation with or without ascending aortic aneurysm: Heart Valve Society Aortic Valve Database Study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:05Z",
  "url": "https://research.draconitic.com/paper/bsk25hrh51zp5",
  "venue": "JTCVS open",
  "versions": []
}