Definitions and study endpoints
The data were extracted from our institutional Aortic Valve Registry, a prospectively maintained clinical registry of all patients undergoing AVR or repair at our institution and double-checked for accuracy (M.M. and A.M.). All operative survivors were followed up regularly and completed in 641 out of 652 patients (98.3%). All clinically gathered data, including adverse events during follow-up and cause of death, were registered and reported according to the standardized institutional protocol.