Aortic valve replacement: current clinical practice and opportunities for quality improvement

This is a review of the current clinical practice and opportunities for qua lity improvement in aortic valve replacement surgery. The topics include tr ends and regional variation in procedure rates, and changes in the use of a ortic valve replacement among the elderly. Recent developments guiding the choice of prosthetic valves and trends in in-hospital mortality rates for a ortic valve surgery are summarized. Lastly, a discussion of topics relevant to clinical practice improvement including the implementation of clinical practice guidelines, the need for consensus on risk adjustment, better unde rstanding of volume-outcome effects, and the opportunities for comprehensiv e assessment of aortic valve surgery. Curr Opin Cardiol 2001, 16:152-157 (C ) 2001 Lippincott Williams & Wilkins, Inc.