Raffi Bekeredjian1,2, Gabor Szabo3, Ümniye Balaban4,5, Sabine Bleiziffer6, Timm Bauer7, Stephan Ensminger8, Christian Frerker9, Eva Herrmann4,5, Friedhelm Beyersdorf10, Christian Hamm11, Andreas Beckmann12, Helge Möllmann13, Matthias Karck3, Hugo A Katus1, Thomas Walther14. 1. Department of Cardiology, University Hospital Heidelberg, Im Neuenheimer Feld 410, Heidelberg, Germany. 2. Department of Cardiology, Robert-Bosch-Hospital Stuttgart, Auerbachstrasse 110, Stuttgart, Germany. 3. Department of Cardiac Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 110, Heidelberg, Germany. 4. Institute of Biostatistics and Mathematical Modelling, Goethe-University Frankfurt, Theodor-Stern-Kai 7, Frankfurt, Germany. 5. German Center for Cardiovascular Research, DZHK, Partner Site Heidelberg, Theodor-Stern-Kai 7, Frankfurt, Germany. 6. Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität, Lazarettstr. 36, Munich, Gemany. 7. Department of Cardiology, University Hospital Gießen, Klinikstrasse 33, Gießen, Germany. 8. Department of Cardiac Surgery, University of Lübeck, Ratzeburger Allee 160, Lübeck, Germany. 9. Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstrasse 5, Hamburg, Germany. 10. Department of Cardiovascular Surgery, University of Freiburg, Hugstetter Strasse 55, Freiburg, Germany. 11. Department of Cardiology, Kerckhoff Klinik Bad Nauheim, Benekestr. 2-8, Bad Nauheim, Germany. 12. German Society for Thoracic and Cardiovascular Surgery, Langenbeck-Virchow-Haus, Luisenstr. 58-59, Berlin, Germany. 13. Department of Cardiology, St.-Johannes Hospital Dortmund, Johannesstrasse 9-17, Dortmund, Germany. 14. Department of Cardiothoracic Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, Frankfurt, Germany.
Abstract
AIMS: Transcatheter aortic valve implantation (TAVI) has become the standard treatment for patients with severe aortic valve stenosis at high surgical risk and may be considered for patients with intermediate risk. During the last few years, an increasing number of patients with low surgical risk have been treated with TAVI. In this study, low-risk patients undergoing isolated TAVI or surgical aortic valve replacement (SAVR) were analysed using data from the German Aortic Valve Registry (GARY). METHODS AND RESULTS: All patients with a Society of Thoracic Surgeons Score of <4% undergoing TAVI or SAVR in 2014 and 2015 were evaluated. A total of 20 549 low surgical risk patients remained for further analysis, comprising 14 487 surgical patients and 6062 TAVI patients. Since TAVI patients were significantly older and had significantly more co-morbidities, a weighted propensity score model was used to compare SAVR and TAVI patients for in-hospital, 30-day, and 1-year mortality. Transcatheter aortic valve implantation patients showed a significantly higher in-hospital and 30-day survival than SAVR patients (in hospital survival TAVI vs. SAVR: 98.5% vs. 97.3%; P = 0.003; 30-day survival TAVI vs. SAVR: 98.1% vs. 97.1%; P = 0.014). At 1 year, survival rates did not differ significantly (survival TAVI vs. SAVR: 90.0% vs. 91.2%; P = 0.158). CONCLUSION: In this first GARY analysis of low-risk patients, weighted comparison showed similar 1-year survival for TAVI and SAVR and higher in-hospital survival for TAVI patients. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Transcatheter aortic valve implantation (TAVI) has become the standard treatment for patients with severe aortic valve stenosis at high surgical risk and may be considered for patients with intermediate risk. During the last few years, an increasing number of patients with low surgical risk have been treated with TAVI. In this study, low-risk patients undergoing isolated TAVI or surgical aortic valve replacement (SAVR) were analysed using data from the German Aortic Valve Registry (GARY). METHODS AND RESULTS: All patients with a Society of Thoracic Surgeons Score of <4% undergoing TAVI or SAVR in 2014 and 2015 were evaluated. A total of 20 549 low surgical risk patients remained for further analysis, comprising 14 487 surgical patients and 6062 TAVI patients. Since TAVI patients were significantly older and had significantly more co-morbidities, a weighted propensity score model was used to compare SAVR and TAVI patients for in-hospital, 30-day, and 1-year mortality. Transcatheter aortic valve implantationpatients showed a significantly higher in-hospital and 30-day survival than SAVR patients (in hospital survival TAVI vs. SAVR: 98.5% vs. 97.3%; P = 0.003; 30-day survival TAVI vs. SAVR: 98.1% vs. 97.1%; P = 0.014). At 1 year, survival rates did not differ significantly (survival TAVI vs. SAVR: 90.0% vs. 91.2%; P = 0.158). CONCLUSION: In this first GARY analysis of low-risk patients, weighted comparison showed similar 1-year survival for TAVI and SAVR and higher in-hospital survival for TAVI patients. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Luise Gaede; Johannes Blumenstein; Christoph Liebetrau; Oliver Dörr; Won-Keun Kim; Holger Nef; Oliver Husser; Jan Gülker; Albrecht Elsässer; Christian W Hamm; Stephan Achenbach; Helge Möllmann Journal: Clin Res Cardiol Date: 2019-06-24 Impact factor: 5.460
Authors: Helge Möllmann; Oliver Husser; Johannes Blumenstein; Christoph Liebetrau; Oliver Dörr; Won-Keun Kim; Holger Nef; Christian Tesche; Christian W Hamm; Albrecht Elsässer; Stephan Achenbach; Luise Gaede Journal: Clin Res Cardiol Date: 2019-10-01 Impact factor: 5.460
Authors: Raj R Makkar; Sung-Han Yoon; Tarun Chakravarty; Samir R Kapadia; Amar Krishnaswamy; Pinak B Shah; Tsuyoshi Kaneko; Eric R Skipper; Michael Rinaldi; Vasilis Babaliaros; Sreekanth Vemulapalli; Alfredo Trento; Wen Cheng; Susheel Kodali; Michael J Mack; Martin B Leon; Vinod H Thourani Journal: JAMA Date: 2021-09-21 Impact factor: 56.272