Abstract
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: The overall 15-year survival rate was neither different from that of the Japanese general population (87.4% vs 90.0%, P = .899) nor significantly different when patients were stratified by age ≤60 years (88.8% vs 93.0%, log-rank P = .563) and ≤50 years (95.3% vs 97.0%, log-rank P = .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.