Optimizing the lifetime surgical management of congenital aortic valve disease

This thesis aims to examine the long-term surgical outcome and clinical course of congenital aortic valve disease across the age spectrum by employing microsimulation models and longitudinal mixed-effects models, to better support patient-tailored decisionmaking and optimize the lifetime surgical management of patients with aortic valve disease. To achieve this aim the following research questions were postulated: - What do the natural course and treatment pathways of severe aortic stenosis in children look like? Can watchful waiting be an alternative to immediate intervention (Chapter 2)? - What characterizes long-term outcome after surgical repair of valvar aortic stenosis, supravalvular aortic stenosis or aortic valve regurgitation in children (Chapters 3 and 5)? - What characterizes long-term clinical outcome after surgical aortic valve replacement with currently available valve substitutes for aortic valve disease in children (Chapter 4)? - What characterizes long-term outcome after reconstructive surgical treatment options for aortic valve disease in nonelderly adults, such as aortic valve repair and the Ross procedure (Chapters 6, 7 and 8)? - How can microsimulation be optimally implemented to better support the lifetime management of patients diagnosed with heart valve disease (Chapter 9)?