Surgical techniques

All patients underwent AVR with/without concomitant surgery using standard cardiopulmonary bypass (CPB) via median (n = 147) or three patients via partial upper sternotomy under moderate hypothermia (n = 146). Four patients underwent dilated or/and calcified ascending aorta replacement under hypothermic circulatory arrest. The decision to use a biological (tissue) or mechanical valve prosthesis and selection of the valve was left to the preference of the surgeons and patients. In addition, all patients were analysed according to the complexity of the operation on the AVR, AVR ± CABG ± other surgery, and AVR ± other surgery groups.