Ole De Backer1, Ngai H V Luk2, Niels T Olsen2, Peter S Olsen3, Lars Søndergaard2. 1. Department of Cardiology, The Heart Center, Righospitalet, Copenhagen University Hospital, Copenhagen, Denmark. Electronic address: ole.debacker@gmail.com. 2. Department of Cardiology, The Heart Center, Righospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 3. Department of Cardiothoracic Surgery, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Abstract
OBJECTIVES: The aim of this study was to evaluate the choice of treatment for severe aortic valve stenosis in the era of transcatheter aortic valve replacement (TAVR) in Eastern Denmark. BACKGROUND: Until the early 21st century, the only therapeutic option for aortic valve stenosis was surgical aortic valve replacement (SAVR), but this has changed with the introduction of TAVR. METHODS: Using the East Denmark Heart Registry, the evolution of AVR over time was studied for the period 2005 to 2015. RESULTS: TAVR has since its introduction in 2007 seen steady growth, with currently more than 35% of AVR procedures-and 45% of isolated AVR procedures-being performed by transcatheter-based technology. The number of SAVR procedures remained rather stable over the study period and even saw a slight decline since 2012-there was a marked decrease in the age at which surgical bioprostheses are considered appropriate. The age profile of TAVR patients remained unchanged over the study period, with a recent trend toward more low- and intermediate-risk patients. Currently, patients age ≥80 years and/or with a Society of Thoracic Surgeons (STS) surgical risk score >6 are automatically referred for TAVR, and one-half of patients age 70 to 80 years with an STS risk score of 4 to 6 are treated with TAVR. CONCLUSIONS: The number of TAVR procedures has increased steadily in recent years, with a TAVR penetration rate of 35% in 2015 and close to 45% when considering isolated AVR. The number of SAVR procedures remained stable over the study period, and surgical bioprostheses are currently used at a much younger age than in 2005.
OBJECTIVES: The aim of this study was to evaluate the choice of treatment for severe aortic valve stenosis in the era of transcatheter aortic valve replacement (TAVR) in Eastern Denmark. BACKGROUND: Until the early 21st century, the only therapeutic option for aortic valve stenosis was surgical aortic valve replacement (SAVR), but this has changed with the introduction of TAVR. METHODS: Using the East Denmark Heart Registry, the evolution of AVR over time was studied for the period 2005 to 2015. RESULTS: TAVR has since its introduction in 2007 seen steady growth, with currently more than 35% of AVR procedures-and 45% of isolated AVR procedures-being performed by transcatheter-based technology. The number of SAVR procedures remained rather stable over the study period and even saw a slight decline since 2012-there was a marked decrease in the age at which surgical bioprostheses are considered appropriate. The age profile of TAVR patients remained unchanged over the study period, with a recent trend toward more low- and intermediate-risk patients. Currently, patients age ≥80 years and/or with a Society of Thoracic Surgeons (STS) surgical risk score >6 are automatically referred for TAVR, and one-half of patients age 70 to 80 years with an STS risk score of 4 to 6 are treated with TAVR. CONCLUSIONS: The number of TAVR procedures has increased steadily in recent years, with a TAVR penetration rate of 35% in 2015 and close to 45% when considering isolated AVR. The number of SAVR procedures remained stable over the study period, and surgical bioprostheses are currently used at a much younger age than in 2005.
Authors: Harun Kundi; Jeffrey J Popma; Kamal R Khabbaz; Louis M Chu; Jordan B Strom; Linda R Valsdottir; Changyu Shen; Robert W Yeh Journal: JAMA Cardiol Date: 2019-01-01 Impact factor: 14.676
Authors: Marko P O Virtanen; Markku Eskola; Maina P Jalava; Annastiina Husso; Teemu Laakso; Matti Niemelä; Tuomas Ahvenvaara; Tuomas Tauriainen; Pasi Maaranen; Eeva-Maija Kinnunen; Sebastian Dahlbacka; Jussi Jaakkola; Tuija Vasankari; Juhani Airaksinen; Vesa Anttila; Stefano Rosato; Paola D'Errigo; Mikko Savontaus; Tatu Juvonen; Mika Laine; Timo Mäkikallio; Antti Valtola; Peter Raivio; Fausto Biancari Journal: JAMA Netw Open Date: 2019-06-05