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Life Expectancy after
Aortic Valve Replacement

The Ross procedure is the only option for aortic valve replacement that provides patients the same life-expectancy after surgery as someone their same age and gender who does not have aortic valve disease.1

Life expectancy after aortic valve replacement (AVR) is primarily determined by the patient’s age at the time of surgery – the younger the patient is when their valve is replaced, the more years they risk losing from their life expectancy.2 Additionally, the choice of procedure as well as valve type play a significant role in the patient’s anticipated life span.

The younger adult patients, those under the age of 60, with aortic valve disease can be a challenging population for valve replacement, but the Ross procedure continues to be the only AVR option proven to restore a patient’s life expectancy as if they did not have aortic valve disease.2-4

Although AVR is a common cardiac surgery with various procedure and valve types to choose from, patients who are ≤60 years old at the time of surgery have a higher risk of reduced life expectancy if they have a bioprosthetic (“tissue”) or mechanical valve implanted compared to a Ross procedure.4-6

In a study with over 2,500 patients who all received a bioprosthetic aortic valve, patients who were ~40 years old at the time of surgery had their life expectancy reduced by 20 years compared to the general population.7 (Figure A)

Figure A. Effect on Life Expectancy After Aortic Valve Replacement (AVR) with a Tissue Valve7

*Adapted from Bouhout et al.7

This data emphasizes the importance and impact of valve choice on life expectancy for younger patients. As the use of bioprosthetic valves in younger patients is increasing, it is important to discuss life expectancy and other core considerations with your physician(s) as you determine which procedure and valve type is right for you.

Learn about life expectancy after the Ross procedure from Dr. Ismail El‑Hamamsy.

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  1. El-Hamamsy I, et al. (2010). Long-term outcomes after autograft versus homograft aortic root replacement in adults with aortic valve disease: a randomised controlled trial. Lancet, 376(9740), 524-31. https://doi: 10.1016/S0140-6736(10)60828-8.
  2. El-Hamamsy I, et al. (2022). Propensity-Matched Comparison of the Ross Procedure and Prosthetic Aortic Valve Replacement in Adults. Journal of the American College of Cardiology, 79(8), 805–15. https://doi.org/10.1016/j.jacc.2021.11.057.
  3. Aboud A, et al. (2021). Long-Term Outcomes of Patients Undergoing the Ross Procedure. Journal of the American College of Cardiology, 77, 1412–22. https://doi.org/10.1016/j.jacc.2021.01.034.
  4. Mazine A, et al. (2018). Ross Procedure in Adults for Cardiologists and Cardiac Surgeons: JACC State-of-the-Art Review. Journal of the American College of Cardiology, 72(22), 2761-77. https://doi.org/10.1016/j.jacc.2018.08.2200.
  5. Kvidal P, et al. (2000). Observed and Relative Survival After Aortic Valve Replacement. Journal of the American College of Cardiology, 35(3), 747-56. https://doi.org/10.1016/S0735-1097(99)00584-7.
  6. Bouhout I, et al. (2014). Long-term outcomes after elective isolated mechanical aortic valve replacement in young adults. The Journal of Thoracic and Cardiovascular Surgery, 148(4), 1341-46.e1. http://dx.doi.org/10.1016/j.jtcvs.2013.10.064.
  7. Bourguignon T, et al. (2015). Very Long-Term Outcomes of the Carpentier-Edwards Perimount Valve in Aortic Position. The Annals of Thoracic Surgery, 99(3), 831-37. http://dx.doi.org/10.1016/j.athoracsur.2014.09.030.

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