Moderate or severe aortic valve disease in patients with successful rheumatic mitral and tricuspid valve repair: Efforts to repair valve

Objective: The management of aortic valve (AV) disease in patients with rheumatic heart disease (RHD) undergoing multivalve surgery remains uncertain. This study aimed to compare the long-term outcomes of AV repair versus AV replacement in patients with RHD undergoing combined mitral and tricuspid valve repair. Methods: We conducted a retrospective cohort study of 288 patients with RHD who underwent combined mitral and tricuspid valve repair with either AV repair (n = 122) or AV replacement (n = 166) at Beijing Anzhen Hospital from January 2015 to August 2024. The primary outcomes were overall survival and freedom from valve-related events. Kaplan-Meier survival analysis and inverse probability of treatment weighting were used to adjust for baseline differences and compare the groups. Results: = .21) between the 2 groups, with curves adjusted by inverse probability of treatment weighting showing consistent results. Conclusions: AV repair is a feasible and safe alternative to replacement in selected patients with RHD undergoing multivalve surgery, offering favorable early hemodynamics and comparable midterm outcomes.