Transcatheter versus Surgical Aortic Valve Replacement in High-risk Patients: A propensity-score matched analysis
| Autor: | William Y. Shi, Robert Whitbourn, India Zweng, Andrew Newcomb, Philip Davis, Andrew I. MacIsaac, Sonny Palmer |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty 030204 cardiovascular system & hematology Disease-Free Survival Transcatheter Aortic Valve Replacement 03 medical and health sciences 0302 clinical medicine Aortic valve replacement Risk Factors Internal medicine medicine Humans 030212 general & internal medicine Propensity Score Survival rate Aged Aged 80 and over High risk patients business.industry Aortic Valve Stenosis Middle Aged Risk adjustment medicine.disease Surgery Cardiac surgery Survival Rate Aortic valve stenosis Propensity score matching Cohort Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Heart, Lung and Circulation. 25:661-667 |
| ISSN: | 1443-9506 |
| DOI: | 10.1016/j.hlc.2016.01.005 |
| Popis: | There is limited data from Australia and New Zealand comparing transcatheter aortic valve implantation (TAVI) with conventional surgical aortic valve replacement (sAVR).Between 2009 and 2015, 64 patients underwent TAVI and 669 underwent sAVR at a single centre. Patients' peri-operative details were analysed and compared between groups. Propensity-score matching was performed for risk adjustment.Patients receiving TAVI were older (mean age in years TAVI: 83.9±4.6 vs. sAVR: 71±9.9, P0.001), and were more likely to be female (TAVI: 67%, 43/64, vs. sAVR: 32%, 217/669, P0.001). Unadjusted 30-day mortality was comparable between groups (2/64, 3% vs. 22/669, 3%, P0.99). The matched analysis revealed comparable 30-day mortality (TAVI: 2/44, 5% vs. sAVR: 2/44, 5%, P0.99). New atrial arrhythmia occurred more frequently within the sAVR cohort (TAVI: 1/44, 2% vs. sAVR 18/44, 41%, P0.001). Complete heart block requiring permanent pacemaker was more frequent amongst the TAVI cohort (TAVI: 10/44, 23% vs. sAVR 2/44, 5%, P=0.039). At two years, survival was comparable between groups (TAVI: 74±1.7 vs. sAVR: 80±0.1%, P=0.65).This single centre experience suggests that TAVI is a valuable treatment option for high-risk surgical patients with comparable survival. |
| Databáze: | OpenAIRE |
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