Key result
SAVR in patients aged ≤65 yields long-term survival equivalent to the matched general population.
Why the study?
Accurate assessment of long-term outcomes after surgical aortic valve replacement in young adults aged ≤65 years has become more pertinent with widespread use of transcatheter aortic valve implantation.
Does primary surgical aortic valve replacement result in equivalent long-term survival compared to the general population in patients aged ≤65 years?
Cohort (n=343)
Does primary surgical aortic valve replacement result in equivalent long-term survival compared to the general population in patients aged ≤65 years?
Effect estimate: SMR 1.033 (95% CI 0.584-1.829)
p-value: p=0.657
Long-term survival after surgical aortic valve replacement in patients aged ≤65 years is equivalent to that of the age- and sex-matched general population, providing a benchmark for future comparisons with transcatheter approaches.
Background: With the widespread use of transcatheter aortic valve implantation, accurate assessment of the long-term outcomes of surgical aortic valve replacement has become more pertinent, particularly in young adults. The aim of this study was to clarify the long-term survival after surgical aortic valve replacement for patients aged ≤65 years compared with the age- and sex-matched Japanese general population. Methods: This study analyzed 343 patients, aged ≤65 years (mean age, 53.2 ± 10.5 years), who underwent primary surgical aortic valve replacement with bioprosthetic or mechanical prosthetic valves from 2001 to 2021. The overall survival rate after surgical aortic valve replacement was compared with an age- and sex-matched Japanese general population. The median follow-up period was 80 months (interquartile range, 43-125 months). Results: = .657). The standardized mortality ratios in the entire cohort (aged ≤65 years) and in patients aged ≤60 and ≤50 years were 1.033 (95% CI, 0.584-1.829), 1.213 (95% CI, 0.584-2.518), and 1.367 (95% CI, 0.320-5.849), respectively. Conclusions: The survival rate after surgical aortic valve replacement in young adults aged ≤65 years was equivalent to that of the age- and sex-matched Japanese general population. Our data may help guide future therapeutic comparisons for patients aged ≤65 years requiring aortic valve procedures.
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Hirayama et al. (2025) conducted a cohort in Aortic valve disease requiring surgical replacement (n=343). Surgical aortic valve replacement vs. Age- and sex-matched Japanese general population was evaluated on Overall survival (SMR 1.033, 95% CI 0.584-1.829, p=0.657). Surgical aortic valve replacement in patients aged ≤65 years resulted in long-term survival equivalent to the matched general population (SMR 1.033; 95% CI 0.584-1.829; P=0.657).
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