BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become a therapeutic alternative to surgery for the treatment of severe aortic stenosis in high-surgical risk patients. The aim of this study was to compare 30-day mortality of high-risk patients treated by TAVI versus surgical aortic valve replacement. METHODS: A total of 175 patients (60 men; mean age, 80±6 years; Euroscore 21±13%) having undergone TAVI were compared with 175 matched patients (76 men; mean age, 79±3 years; Euroscore 17±9%), which have undergone conventional aortic valve replacement and were deemed to be high-risk patients by the cardiothoracic surgeons. Thirty-day mortality and major adverse events were recorded in both groups. Patients' characteristics were analyzed for predictors of mortality in the TAVI group. RESULTS: Twenty-one patients (12%) in the TAVI group and 13 patients (8%) in the surgical group died within 30 days of the procedure (P=0.165). Two patients (1%) in the TAVI group and one patient (0.5%) in the conventional surgery group had a major stroke (P=1.0). Seven patients (4%) in the TAVI group and 25 patients (14%) in the conventional surgery group required dialysis post procedure (P=0.0013). The average length of stay in the intensive care unit was lower in the TAVI group compared with the conventional surgical group (3.3±3.1 vs. 6.6±10.5 days; P<0.001). Age was the only independent predictor of mortality in the TAVI group (odds ratio=1.009; 95% confidence interval: 1.001-1.018 per additional year; P=0.0186) and in the total study population (odds ratio=1.007; 95% confidence interval: 1.001-1.013 per additional year; P=0.0186). CONCLUSION: In high-surgical risk patients, TAVI can be performed at a mortality risk comparable with conventional surgery with a reduced length of post interventional intensive care unit stay and less need for dialysis.
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become a therapeutic alternative to surgery for the treatment of severe aortic stenosis in high-surgical risk patients. The aim of this study was to compare 30-day mortality of high-risk patients treated by TAVI versus surgical aortic valve replacement. METHODS: A total of 175 patients (60 men; mean age, 80±6 years; Euroscore 21±13%) having undergone TAVI were compared with 175 matched patients (76 men; mean age, 79±3 years; Euroscore 17±9%), which have undergone conventional aortic valve replacement and were deemed to be high-risk patients by the cardiothoracic surgeons. Thirty-day mortality and major adverse events were recorded in both groups. Patients' characteristics were analyzed for predictors of mortality in the TAVI group. RESULTS: Twenty-one patients (12%) in the TAVI group and 13 patients (8%) in the surgical group died within 30 days of the procedure (P=0.165). Two patients (1%) in the TAVI group and one patient (0.5%) in the conventional surgery group had a major stroke (P=1.0). Seven patients (4%) in the TAVI group and 25 patients (14%) in the conventional surgery group required dialysis post procedure (P=0.0013). The average length of stay in the intensive care unit was lower in the TAVI group compared with the conventional surgical group (3.3±3.1 vs. 6.6±10.5 days; P<0.001). Age was the only independent predictor of mortality in the TAVI group (odds ratio=1.009; 95% confidence interval: 1.001-1.018 per additional year; P=0.0186) and in the total study population (odds ratio=1.007; 95% confidence interval: 1.001-1.013 per additional year; P=0.0186). CONCLUSION: In high-surgical risk patients, TAVI can be performed at a mortality risk comparable with conventional surgery with a reduced length of post interventional intensive care unit stay and less need for dialysis.
Authors: X Luo; Z Zhao; H Chai; C Zhang; Y Liao; Q Li; Y Peng; W Liu; X Ren; Q Meng; C Chen; M Chen; Y Feng; D Huang Journal: Herz Date: 2015-02-26 Impact factor: 1.443
Authors: Christopher Cao; Su C Ang; Praveen Indraratna; Con Manganas; Paul Bannon; Deborah Black; David Tian; Tristan D Yan Journal: Ann Cardiothorac Surg Date: 2013-01
Authors: Anna Komosa; Bartłomiej Perek; Piotr Rzymski; Maciej Lesiak; Jolanta M Siller-Matula; Marek Grygier; Mateusz Puślecki; Marcin Misterski; Anna Olasińska-Wiśniewska; Mariola Ropacka-Lesiak; Zbigniew Krasiński; Przemysław Niedzielski; Tatiana Mularek-Kubzdela; Barbara Poniedziałek Journal: J Clin Med Date: 2019-09-02 Impact factor: 4.241