{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:49:26Z","timestamp":1792684166222,"version":"4.5.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,9,19]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Establishing surgical criteria for aortic valve replacement (AVR) in severe aortic regurgitation in young adults is challenging due to the lack of evidence\u2010based recommendations. We studied indications for AVR in young adults with severe aortic regurgitation and their outcomes, as well as the relationship between presurgical echocardiographic parameters and postoperative left ventricular (LV) size, function, clinical events, and valve\u2010related complications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Data were collected retrospectively on 172 consecutive adult patients who underwent AVR or repair for severe aortic regurgitation between 2005 and 2019 in a tertiary cardiac center (age at surgery 29 [22\u201341] years, 81% male). One\u2010third underwent surgery before meeting guideline indications. Postsurgery, 65% achieved LV size and function normalization. LV ejection fraction showed no significant change from baseline. A higher presurgical LV end\u2010systolic diameter correlated with a lack of LV normalization (odds ratio per 1\u2010cm increase 2.81,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01). The baseline LV end\u2010systolic diameter cut\u2010off for predicting lack of LV normalization was 43\u2009mm. Pre\u2010 and postoperative LV dimensions and postoperative LV ejection fraction predicted clinical events during follow\u2010up. Prosthetic valve\u2010related complications occurred in 20.3% during an average 5.6\u2010year follow\u2010up. Freedom from aortic reintervention was 98%, 96.5%, and 85.4% at 1, 5, and 10\u2009years, respectively.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Young adult patients with increased baseline LV end\u2010systolic diameter or prior cardiac surgery are less likely to achieve LV normalization after AVR. Clinicians should carefully balance the long\u2010term benefits of AVR against procedural risks and future interventions, especially in younger patients. Evidence\u2010based criteria for AVR in severe aortic regurgitation in young adults are crucial to improve outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.029251","type":"journal-article","created":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T10:13:07Z","timestamp":1695031987000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Repair of Aortic Regurgitation in Young Adults: Sooner Rather Than Later"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8246-5906","authenticated-orcid":false,"given":"Ana","family":"Barradas\u2010Pires","sequence":"first","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Cardiology Department, Royal Brompton Hospital Guy\u2019s and St Thomas\u2019 NHS Foundation Trust London United Kingdom"},{"name":"Department of Medicine Autonomous University of Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Mer\u00e1s","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Cardiology Department, Royal Brompton Hospital Guy\u2019s and St Thomas\u2019 NHS Foundation Trust London United Kingdom"},{"name":"Cardiology Department University Hospital La Paz Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Constantine","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Cardiology Department, Royal Brompton Hospital Guy\u2019s and St Thomas\u2019 NHS Foundation Trust London United Kingdom"},{"name":"National Heart and Lung Institute Imperial College London London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7453-7594","authenticated-orcid":false,"given":"Giulia","family":"Costola","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Cardiology Department, Royal Brompton Hospital Guy\u2019s and St Thomas\u2019 NHS Foundation Trust London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0269-5574","authenticated-orcid":false,"given":"Teresa Segura","family":"de la Cal","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Cardiology Department, Royal Brompton Hospital Guy\u2019s and St Thomas\u2019 NHS Foundation Trust London United Kingdom"},{"name":"Cardiology Department University Hospital 12 de Octubre Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isma","family":"Rafiq","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Cardiology Department, Royal Brompton Hospital Guy\u2019s and St Thomas\u2019 NHS Foundation Trust London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksander","family":"Kempny","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Cardiology Department, Royal Brompton Hospital Guy\u2019s and St Thomas\u2019 NHS Foundation Trust London United Kingdom"},{"name":"National Heart and Lung Institute Imperial College London London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Li","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Cardiology Department, Royal Brompton Hospital Guy\u2019s and St Thomas\u2019 NHS Foundation Trust London United Kingdom"},{"name":"National Heart and Lung Institute Imperial College London London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1558-8447","authenticated-orcid":false,"given":"Sonya V.","family":"Babu\u2010Narayan","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Cardiology Department, Royal Brompton Hospital Guy\u2019s and St Thomas\u2019 NHS Foundation Trust London United Kingdom"},{"name":"National Heart and Lung Institute Imperial College London London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Andreas","family":"Hoschtitzky","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London London United Kingdom"},{"name":"Cardiothoracic and Congenital Heart Surgery, The Royal Brompton Hospital Guy\u2019s and St Thomas\u2019 NHS Foundation Trust London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Gatzoulis","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Cardiology Department, Royal Brompton Hospital Guy\u2019s and St Thomas\u2019 NHS Foundation Trust London United Kingdom"},{"name":"National Heart and Lung Institute Imperial College London London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio Martinez","family":"Rubio","sequence":"additional","affiliation":[{"name":"Department of Medicine Autonomous University of Barcelona Barcelona Spain"},{"name":"Cardiology Department University Hospital Parc Tauli Sabadell Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1300-0504","authenticated-orcid":false,"given":"Konstantinos","family":"Dimopoulos","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Cardiology Department, Royal Brompton Hospital Guy\u2019s and St Thomas\u2019 NHS Foundation Trust London United Kingdom"},{"name":"National Heart and Lung Institute Imperial College London London United 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