Treating the patients in the 'grey-zone' with aortic valve disease: a comparison among conventional surgery, sutureless valves and transcatheter aortic valve replacement
| Autor: | Alberto Repossini, Claudio Muneretto, Gianluigi Bisleri, Manfredo Rambaldini, Lorenzo Di Bacco, Maurizio Tespili, Annalisa Moggi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Cardiac Catheterization Percutaneous Time Factors medicine.medical_treatment Comorbidity Kaplan-Meier Estimate Prosthesis Design Prosthesis Severity of Illness Index Postoperative Complications Aortic valve replacement Valve replacement Risk Factors medicine.artery Internal medicine Medicine Humans Heart valve Hospital Mortality Prospective Studies Aged Aged 80 and over Heart Valve Prosthesis Implantation Aorta Ejection fraction Chi-Square Distribution business.industry Perioperative Aortic Valve Stenosis medicine.disease Surgery medicine.anatomical_structure Logistic Models Treatment Outcome Aortic Valve Heart Valve Prosthesis Cardiology Female Cardiology and Cardiovascular Medicine business |
| Popis: | OBJECTIVES: Although the use of transcatheter aortic valve replacement (TAVR) has recently become an attractive strategy in extremely high-risk patients undergoing aortic valve replacement (AVR), the most appropriate treatment option in patients with an intermediate- to high-risk profile with conventional surgery (sAVR), TAVR or novel options, such as sutureless valves, has been widely debated. METHODS: One hundred and sixty-three consecutive patients with intermediate to high risk were prospectively enrolled and selected to undergo sAVR (Group 1: G1, n = 55), sutureless valve implantation (Group 2: G2, n = 53) or TAVR (Group 3: G3, n = 55) following a multidisciplinary evaluation including frailty, anatomy and degree of atherosclerotic disease of the aorta/peripheral vessels. The mean logistic EuroSCORE (G1 = 21.3 ± 12.7 vs G2 = 16 ± 11.7 vs G3 = 20.4 ± 12.7, P = 0.06) and preoperative demographics, such as age, gender and left ventricular ejection fraction, were similar: of note, chronic obstructive pulmonary disease was more frequent in TAVI patients (G1 = 27.2% vs G2 = 15.1% vs G3 = 47%; P |
| Databáze: | OpenAIRE |
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