Daniel Wendt1, Fadi Al-Rashid2, Philipp Kahlert2, Karim El-Chilali2, Ender Demircioglu3, Markus Neuhäuser4, Oliver Liakopoulos3, Daniel Sebastian Dohle3, Raimund Erbel2, Heinz Jakob3, Matthias Thielmann3. 1. Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany. Electronic address: daniel.wendt@uk-essen.de. 2. Department of Cardiology, West-German Heart and Vascular Center Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany. 3. Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany. 4. Department of Mathematics and Technique, Koblenz University of Applied Science, RheinAhrCampus Remagen and the Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany.
Abstract
BACKGROUND: Clinical outcomes were compared among patients with previous cardiac surgery undergoing transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (AVR). METHODS: Between 2007 and 2014 a total of 142 consecutive patients with previous cardiac surgery were treated by TAVI either by the transfemoral (n=68) or transapical access (n=74), and 236 patients underwent a surgical redo-AVR. Of these patients, propensity analysis (m:n) matched 62 (group 1, TAVI) and 51 patients (group 2, redo-AVR). A multivariate logistic regression model was constructed. Moreover, mortality was compared between both groups by Cox regression. RESULTS: Both groups differed significantly (p<0.01) in regard to age and preoperative risk scores (EuroSCORE and STS-Score). Thirty-day mortality was 14.5% (9/62) in group 1 and 5.8% (3/51) in group 2 (p=0.23). Risk-adjusted multivariable analysis revealed only the logistic EuroSCORE to be strongly correlated with 30-day mortality (p=0.01). Multivariate analysis showed no difference in 30-day mortality between both groups (p=0.21). Multivariate Cox regression revealed New York Heart Association functional class (p=0.001), logistic EuroSCORE (p=0.01), and STS-Score (p=0.03) to be strongly associated with overall mortality. Moreover, evaluating overall mortality, Cox regression showed no difference between both groups (p=0.36). CONCLUSIONS: The present study shows that in patients with cardiac reoperation, TAVI comes with similar outcomes when compared to surgical AVR. On the other hand, conventional redo-AVR is still a valuable and safe treatment option.
BACKGROUND: Clinical outcomes were compared among patients with previous cardiac surgery undergoing transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (AVR). METHODS: Between 2007 and 2014 a total of 142 consecutive patients with previous cardiac surgery were treated by TAVI either by the transfemoral (n=68) or transapical access (n=74), and 236 patients underwent a surgical redo-AVR. Of these patients, propensity analysis (m:n) matched 62 (group 1, TAVI) and 51 patients (group 2, redo-AVR). A multivariate logistic regression model was constructed. Moreover, mortality was compared between both groups by Cox regression. RESULTS: Both groups differed significantly (p<0.01) in regard to age and preoperative risk scores (EuroSCORE and STS-Score). Thirty-day mortality was 14.5% (9/62) in group 1 and 5.8% (3/51) in group 2 (p=0.23). Risk-adjusted multivariable analysis revealed only the logistic EuroSCORE to be strongly correlated with 30-day mortality (p=0.01). Multivariate analysis showed no difference in 30-day mortality between both groups (p=0.21). Multivariate Cox regression revealed New York Heart Association functional class (p=0.001), logistic EuroSCORE (p=0.01), and STS-Score (p=0.03) to be strongly associated with overall mortality. Moreover, evaluating overall mortality, Cox regression showed no difference between both groups (p=0.36). CONCLUSIONS: The present study shows that in patients with cardiac reoperation, TAVI comes with similar outcomes when compared to surgical AVR. On the other hand, conventional redo-AVR is still a valuable and safe treatment option.
Authors: Alina Zubarevich; Marcin Szczechowicz; Konstantin Zhigalov; Philipp Marx; Alexander Lind; Rolf Alexander Jánosi; Tienush Rassaf; Sharaf-Eldin Shehada; Rizwan Malik; Markus Kamler; Matthias Thielmann; Bastian Schmack; Arjang Ruhparwar; Alexander Weymann; Daniel Wendt Journal: Ann Cardiothorac Surg Date: 2021-09
Authors: Sharaf-Eldin Shehada; Yacine Elhmidi; Öznur Öztürk; Markus Kasel; Antonio H Frangieh; Fanar Mourad; Jaroslav Benedik; Jaafar El Bahi; Mohamed El Gabry; Matthias Thielmann; Heinz Jakob; Daniel Wendt Journal: Cardiol Res Pract Date: 2018-04-05 Impact factor: 1.866
Authors: Alina Zubarevich; Marcin Szczechowicz; Arian Arjomandi Rad; Robert Vardanyan; Philipp Marx; Alexander Lind; Rolf Alexander Jánosi; Mehdy Roosta-Azad; Rizwan Malik; Markus Kamler; Matthias Thielmann; Mohamed El Gabry; Bastian Schmack; Arjang Ruhparwar; Alexander Weymann; Daniel Wendt Journal: PLoS One Date: 2021-08-25 Impact factor: 3.240