Long-term results of aortic valve replacement.

Many studies document improved short- and long-term survival in patients with severe aortic stenosis or regurgitation after AVR. Despite this, AVR should be considered palliative because the valve prosthesis introduces the patient to a new disease process in which complications include thromboembolism, anticoagulant-related bleeding, infection, and structural deterioration. Significant refinements in valve prostheses have reduced but not eliminated these problems. Furthermore, improvements in surgical technique and myocardial preservation continue to decrease the risks of operation. Long-term improvement in ventricular function has been well documented after AVR and is probably responsible for the improvements in survival we now enjoy.