Impact of treatment choice on the outcome of patients proposed for transcatheter aortic valve implantation
| Autor: | De Carlo M, Salvatore Curello, Minzioni G, Fabio Guarracino, Cristina Giannini, Federica Ettori, Claudia Fiorina, Anna Sonia Petronio, Scioti G, Giuliano Chizzola, Matteo D |
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| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Male
Aortic valve Cardiac Catheterization medicine.medical_specialty medicine.medical_treatment Balloon Prosthesis Catheterization Cohort Studies Aortic valve replacement Interquartile range Internal medicine Humans Medicine Prospective Studies Aged Aged 80 and over Heart Valve Prosthesis Implantation Transcatheter aortic valve implantation business.industry Aortic stenosis Valvuloplasty EuroSCORE medicine.disease Surgery Aortic valvuloplasty Stenosis Treatment Outcome medicine.anatomical_structure Aortic Valve Quality of Life Cardiology Female Cardiology and Cardiovascular Medicine business |
| Popis: | AIMS Transcatheter aortic valve implantation (TAVI) is a new option for patients with severe aortic stenosis at high surgical risk. We compared the clinical outcome of patients referred for TAVI and subsequently treated with TAVI, surgical aortic valve replacement (SAVR), balloon aortic valvuloplasty (BAV), or medical management (MM). METHODS AND RESULTS All consecutive patients (n=166, EuroSCORE 24.9 ± 13.9%) referred for TAVI to our two centres were enrolled in a prospective registry and were assigned to SAVR (n=21), TAVI with the CoreValve prosthesis (n=75), BAV (n=20), or MM (n=50) by a multi-specialty team. The primary endpoint was 6-month cardiac mortality. Patients undergoing BAV had a significantly higher EuroSCORE (33.6 ± 15.9%; p=0.01). Median follow-up time was nine months (interquartile range 4.5-12.4 months). Six-month freedom from cardiac death was 81.0 ± 8.6%, 92.0 ± 3.1%, 72.9 ± 10.5%, and 72.7 ± 6.5% for SAVR, TAVI, BAV, and MM groups, respectively. Freedom from major cardiac and cerebrovascular events was 76.2 ± 9.3%, 83.9 ± 4.3%, 72.9 ± 10.5%, and 65.6 ± 6.8% for SAVR, TAVI, BAV, and MM groups, respectively. CONCLUSIONS With respect to medical management and BAV, TAVI was associated with lower cardiac mortality at six months. Clinical outcome after TAVI was similar to that of less sick patients undergoing SAVR. |
| Databáze: | OpenAIRE |
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