From Technique to Wholeness: A Systemic Approach to Aortic Valve Replacement with Traditional and Rapid-deployment Valves

pp. 293-296

Abstract

In recent decades, the number of patients with aortic valve disease requiring aortic valve replacement (AVR) has increased due to longer life expectancy. Many of these patients, especially those who are elderly and have comorbidities, face high preoperative risk. The complexity of cardiovascular disease and the adaptation of these patients to the intervention require a comprehensive and holistic approach, considering biological, genetic, and psychosocial factors. This article addresses the importance of understanding AVR as part of a complex system, emphasizing the interaction between multiple elements of the cardiovascular system such as the myocardium, conduction system, and coronary circulation, which affect surgical outcomes. It also highlights how the selection of heart valve prosthesis and other unpredictable factors can influence postoperative mortality, which should not be viewed as a simple cause-and-effect phenomenon. The use of advanced technologies, such as artificial intelligence, can improve outcomes in the preoperative, intraoperative, and postoperative phases of treatment. In conclusion, to improve outcomes in patients undergoing surgical RVA, it is essential to adopt a systemic approach, within the framework of complexity theory, that integrates innovative technologies and considers the individual characteristics of each patient. This could contribute to reduce in-hospital mortality.