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Purpose of Review <p>Prosthetic valve replacement has been the cornerstone of aortic regurgitation (AR) management but presents challenges such as the need for lifelong anticoagulation, limited durability, increased risks of thromboembolism, and reduction in life expectancy. This review aims to explore the evolution of AR management, addressing advancements in aortic valve repair (AVr) and the Ross procedure (RP) as patient-centered alternatives to prosthetic valve replacement.</p> Recent Findings <p>Recent innovations have significantly advanced AR management. Valve-sparing techniques, including reimplantation and remodeling, have gained traction due to functional classifications, annular stabilization techniques, and improved imaging, which enhance the durability and applicability of AVr. The RP, replacing the aortic valve with the patient’s pulmonary valve, has shown superior hemodynamics and long-term outcomes, as well as restoration of&#xa0;normal life expectancy for younger patients. Improved surgical techniques, patient selection, and guideline-based frameworks now enable safer and more effective implementation of these approaches.</p> Summary <p>AVr and RP represent durable, physiological, and patient-specific alternatives to prosthetic valve replacement, particularly for individuals at higher risk of prosthetic complications. By tracing the historical context, highlighting modern innovations, and summarizing clinical outcomes, this review underscores the expanding role of these procedures in delivering tailored interventions and improved quality of life for patients with AR.</p>

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Beyond Prosthetic Valve Replacement: Advances in Aortic Valve Repair and the Ross Procedure for Aortic Regurgitation

  • 期刊论文

  • 发表日期：

    2025年2月19日

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  • Lucy Nam,
  • Antonia Kreso,
  • Motahar Hosseini,
  • Thoralf M. Sundt,
  • Jordan P. Bloom

摘要

Purpose of Review

Prosthetic valve replacement has been the cornerstone of aortic regurgitation (AR) management but presents challenges such as the need for lifelong anticoagulation, limited durability, increased risks of thromboembolism, and reduction in life expectancy. This review aims to explore the evolution of AR management, addressing advancements in aortic valve repair (AVr) and the Ross procedure (RP) as patient-centered alternatives to prosthetic valve replacement.

Recent Findings

Recent innovations have significantly advanced AR management. Valve-sparing techniques, including reimplantation and remodeling, have gained traction due to functional classifications, annular stabilization techniques, and improved imaging, which enhance the durability and applicability of AVr. The RP, replacing the aortic valve with the patient’s pulmonary valve, has shown superior hemodynamics and long-term outcomes, as well as restoration of normal life expectancy for younger patients. Improved surgical techniques, patient selection, and guideline-based frameworks now enable safer and more effective implementation of these approaches.

Summary

AVr and RP represent durable, physiological, and patient-specific alternatives to prosthetic valve replacement, particularly for individuals at higher risk of prosthetic complications. By tracing the historical context, highlighting modern innovations, and summarizing clinical outcomes, this review underscores the expanding role of these procedures in delivering tailored interventions and improved quality of life for patients with AR.