Conservative Aortic Valve Surgery for Aortic Insufficiency and Aneurysms of the Aortic Root FRESH-PEF60156-en Emmanuel LANSAC Conservative Aortic Valve Surgery for Aortic Insufficiency and Aneurysms of the Aortic Root CAVIAAR FRESH-PEF60156-en 60156 FRESH-PEF60156 Isabelle DI CENTA Cécile JOURDAIN Emmanuel LANSAC ASSISTANCE PUBLIQUE HOPITAUX DE PARIS (AP-HP) Epidemiology France Portal (PEF) ASSISTANCE PUBLIQUE HOPITAUX DE PARIS (AP-HP) null Isabelle;DI CENTA Emmanuel;LANSAC operative mortality thromboembolic or haemorrhagic stroke re-operation placement ascending aorta valve endocarditis Health episodes valve death Cardiology and vascular medicine Biological determinants: Genetic predisposition Biological determinants General objective: to demonstrate in a prospective open and multricentric cohort study that aortic valve sparing for patients with aortic root aneurysms and/or dystrophic aortic insufficiency is associated with a 45% increase of 3 year, 5 year, 10 year, 15 year and 20 year-survival rate without increased mortality or morbidity events when compared to mechanical valve replacement (surgical treatment reference). Morbidity and mortality is defined as the occurrence of at least one of the composite endpoint events: death, re-operation and/or re-hospitalisation for infection, bleeding event, thromboembolic event or heart failure Secondary objectives: - To evaluate and compare between both patient groups: the rate of immediate post-operation complications associated with a 3 year, 5 year, 10 year, 15 year and 20 year-survival rate without mortality or morbidity events when evaluated on composite criteria, the changes in quality of life during follow-up using a standardised questionnaire, validated by cardiac surgery, modified SF12 Questionnaire - to evaluate the impact of a teaching programme for a new standardised surgical technique on morbidity and mortality from each investigating surgeon's learning curve and on long-term outcomes (programme combining theoretical and video-assisted surgical procedure training on heart anatomy, first patient surgical mentoring) - To set predictive sonographic criteria: the feasibility of valve repair with promising immediate and long-term postoperative results from early diagnosis of criteria composite outcome: To evaluate the sensitivity and specificity of ultrasound parameters, notably on the risk of reoperation and valvular complications - To assess the impact of clinical monitoring and imaging on operated patients with aortic root dystrophy in order to propose a post-operative care protocol that meets cost-benefit objectives null France Individuals Patients population Male Female Young Adult (19 to 24 years) Adult (25 to 44 years) Middle Aged (45 to 64 years) Aged (65 to 79 years) Aged, 80 and over (80 years and more) over 18 years of age; - aortic root aneurysms without aortic insufficiency or with dystrophic aortic insufficiency regardless of stage (including Marfan and bicuspid diseases), with indications for surgery conformed to American Heart Association or European Society of Cardiology guidelines or dystrophic aortic insufficiency (bicuspid or tricuspid valves) with no aortic root aneurysm with indications for surgery conformed to American Heart Association or European Society of Cardiology; - scheduled valve repair surgery with annuloplasty according to mechanical valve replacement CAVIAAR study protocol; - Signed information letter and informed consent; - covered by social security insurance or access to CMU (beneficiary or assignee). Clinical data Participant-reported health data Biological data Paraclinical data (non-biological) : Imaging Health event/morbidity Health event/mortality Quality of life/health perception Other Through organizations (health services or institutions schools businesses etc.) < 500 individuals Self-administered questionnaire Interview with the participant (including clinical) Observational Study Observational Study Cohort study 77:- 46 conservations valvulaires- 19 remplacements prothétiques mécaniques- 12 exclusions Unknown Restricted access To be decided if data may be used by academic teams To be decided if data may be used by industrial teams Access on specific project only