A nationwide policy shift implemented in 2018 was designed to, among other things, improve the waiting list mortality rate. One unintended consequence, however, is that patients are now more likely to experience a stroke after receiving a new heart.

The initiative is designed to help identify more patients who may require aortic valve replacement. Brian Lindman, MD, provided an update on the project's efforts.

When patients require subsequent noncardiac surgery after a major heart operation, waiting at least 100 days is one way to limit the risk of an adverse event. Read the full analysis in JACC: Advances.

Researchers focused on a relatively young patient population, hoping to learn as much as possible about the surgical valve's safety and effectiveness over an extended period of time. 

Steven Bolling, MD, noted that tricuspid treatments have been linked to consistent benefits in terms of quality of life. However, he said, finding clear improvements in clinical outcomes has been more challenging.

The drug in question, ataciguat, could help heart patients avoid aortic valve replacement—or at least put it off until later in life.

S. Chris Malaisrie, MD, professor of surgery at Northwestern University, explained what these data can tell us about the lifetime management of patients who require aortic valve replacement.

Mitral valve repair was linked to a significant improvement in long-term survival when treating infective endocarditis. Some patients are not good candidates for a repair procedure, however, making replacement the best possible option.