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AVIATOR Initiative: Aortic Valve Insufficiency and Ascending Aorta Aneurysm International Registry.
Frederiek De Heer1, Alain Berrebi2, Michael Borger3, Olivier Bouchot4, Duke Cameron5, Ruggero De Paulis6, Isabella Di Centa7, Laurent De Kerchove8, Gebrine El Khoury8, Ismail El-Hamamsy9, Jolanda Kluin1, Gianclaudio Mecozzi10, Wuliya Mijiti11, Jan Nijs12, Yutaka Okita13, Carlos Porras14, Hans-Joachim Schäfers15, Hartzell Schaff16, Malakh Shrestha17, Johanna Takkenberg18, Jean Louis Vanoverschelde8, Jan Vojacek19, Emmanuel Lansac2.
1University Medical Center Utrecht, Utrecht, Netherlands, 2Institut Mutualiste Montsouris, Paris, France, 3Leipzig Heart Center, Leipzig, Germany, 4Centre Hospitalier Universitaire Dijon, Dijion, France, 5Johns Hopkins Hospital, Baltimore, MD, USA, 6European Hospital, Rome, Italy, 7Hopital Foch, Suresnes, France, 8Cliniques Universitaires Saint-Luc, Brussels, Belgium, 9Montréal Heart Institute, Montréal, QC, Canada, 10Medisch Spectrum Twente, Enschede, Netherlands, 11People Hospital, Urumchi-Xinjiang, China, 12University Hospital, Brussels, Belgium, 13Kobe University, Kobe, Japan, 14Hospital universitario Virgen de la Victoria, Malaga, Spain, 15Saarland University Medical Center, Homburg/Saar, Germany, 16Mayo Clinic, Rochester, MN, USA, 17Hannover Medical School, Hannover, Germany, 18Erasmus University Medical Center, Rotterdam, Netherlands, 19University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.

Objective Current guidelines for patients with aortic valve insufficiency and/or ascending aorta aneurysm are based on small single expert center case series with a limited follow-up duration. The Society of Heart Valve Disease aortic valve repair working group established the international prospective multicentre registry AVIATOR in 2013 to provide sufficient patient numbers, to address key epidemiological and therapeutic issues and to standardize indications for surgery as well as the place of repair versus replacement in aortic valve surgery. Methods All patients, aged 18 years or older, operated for ascending aorta aneurysm (including root and/or supra coronary aorta and aortic dissection) and/or isolated aortic insufficiency (including congenital mixed aortic valve disease), should be enrolled in an intention to treat design. Surgical techniques include valve repair and replacement, valve sparing aortic root replacement and Bentall procedures. Baseline, procedural and early outcome data are collected prospectively during hospital stay. Thereafter annual follow-up will take place. Results The Aviator registry is open to all centers willing to participate to this international collaborative effort with a dedicated online database for each center allowing state-of-the-art evaluation of valve related events. Currently 9 cardio-thoracic surgery centers from France, the Netherlands, Germany, Spain, Belgium, Czech Republic and Slovakia enrolled in the database. They included 140 patients thus far. A project update is given at this meeting. Conclusions The international prospective multicentre AVIATOR registry will allow for acceleration of knowledge on the determinants of outcome in patients with aortic valve insufficiency and/or ascending aorta aneurysm. By combining surgical experience from multiple centers, and applying uniform definitions of echo and outcome parameters, it will become possible to provide a solid evidence base to clarify and standardize the place of repair versus replacement in aortic valve surgery.

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