Early hemodynamics and clinical outcomes of isolated aortic valve replacement with stentless or transcatheter valve in intermediate-risk patients
| Autor: | Gianluigi Bisleri, Thierry Folliguet, Christina Schäfer, Theodor Fischlein, Roberto Di Bartolomeo, Claudio Muneretto, Benjamin Claus, Lorenzo Di Bacco, Alberto Repossini, Herko Grubitzsch, Bruno Passaretti, Laura Giroletti, Giuseppe Santarpino, François Laborde |
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| Přispěvatelé: | Repossini, Alberto, Di Bacco, Lorenzo, Passaretti, Bruno, Grubitzsch, Herko, Schã¤fer, Christina, Claus, Benjamin, Giroletti, Laura, Folliguet, Thierry, Bisleri, Gianluigi, Fischlein, Theodor, Santarpino, Giuseppe, Di Bartolomeo, Roberto, Laborde, Franã§oi, Muneretto, Claudio |
| Rok vydání: | 2016 |
| Předmět: |
Male
Time Factors Hemodynamics intermediate risk 030204 cardiovascular system & hematology stentless aortic prosthesi stentless aortic prosthesis haemodynamic 0302 clinical medicine Aortic valve replacement Risk Factors transcatheter aortic valve 030212 general & internal medicine Cardiac skeleton Hospital Mortality Heart Valve Prosthesis Implantation education.field_of_study Prognosis Europe Survival Rate Echocardiography Aortic Valve Heart Valve Prosthesis Cardiology Female transcatheter aortic valves Cardiology and Cardiovascular Medicine Pulmonary and Respiratory Medicine medicine.medical_specialty haemodynamics small aortic annulus Surgery Population Prosthesis Design Transcatheter Aortic Valve Replacement 03 medical and health sciences Internal medicine medicine Humans education Aged Retrospective Studies business.industry small aortic annulu Odds ratio Aortic Valve Stenosis medicine.disease Confidence interval Implant Intermediate risk business Follow-Up Studies |
| Zdroj: | The Journal of thoracic and cardiovascular surgery. 153(3) |
| ISSN: | 1097-685X |
| Popis: | Objective Stentless aortic valves have been developed to overcome obstructive limitations associated with stented bioprostheses. The aim of the current multi-institutional study was to compare hemodynamics of transcatheter (TAVR) and the Freedom SOLO Stentless (FS) valve in an intermediate risk population undergoing surgical aortic valve replacement. Methods From 2010 to 2014, 420 consecutive patients underwent isolated surgical aortic valve replacement with FS and 375 patients underwent TAVR. Only patients with intermediate operative risk (Society of Thoracic Surgeons score 4-10) and small aortic annulus (â¤23 mm) were included. After a propensity matched analysis 142 patients in each group were selected. Thirty-day postoperative clinical and echocardiographic parameters were evaluated. Results Mean prosthesis diameter was 22.2 ± 0.9 mm for FS and 22.4 ± 1.0 mm for TAVR. In-hospital mortality was 2.1% for FS and 6.3% for TAVR (P = .02). Postoperative FS peak gradients were 19.1 ± 9.6 mm Hg (mean 10.8 ± 5.9 mm Hg); TAVR peak gradients were 20.2 ± 9.5 mm Hg (mean 10.7 ± 6.9 mm Hg) P = .57 (P = .88). Postoperative effective orifice area was 1.93 ± 0.52 cm2for FS and 1.83 ± 0.3 cm2for TAVR (P = .65). There was no prostheses-patient mismatch in either group. Postoperative grade 2-3 paravalvular leak was present in 3.5% for TAVR and 0.7% for FS. Postoperative permanent pacemaker implant rate was 12% for TAVR and only 1 case (0.7%) in the FS group (P |
| Databáze: | OpenAIRE |
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