Eight-year outcomes for patients with aortic valve stenosis at low surgical risk randomized to transcatheter vs. surgical aortic valve replacement
| Autor: | Henrik Nissen, Daniel Andreas Steinbrüchel, Petur Petursson, Bo Juel Kjeldsen, Nikolaj Ihlemann, Lars Søndergaard, Peter Skov Olsen, Troels H. Jørgensen, Hans Gustav Hørsted Thyregod |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Bioprosthetic aortic valve durability 030204 cardiovascular system & hematology Bioprosthetic valve Transcatheter Aortic Valve Replacement 03 medical and health sciences 0302 clinical medicine Life Expectancy Aortic valve replacement Risk Factors Clinical Research Internal medicine medicine Humans In patient AcademicSubjects/MED00200 030212 general & internal medicine Myocardial infarction Mortality Stroke Aged Aged 80 and over Heart Valve Prosthesis Implantation Transcatheter aortic valve implantation business.industry Surgical aortic valve replacement Aortic Valve Stenosis medicine.disease Surgical risk Clinical trial Editor's Choice Treatment Outcome Aortic Valve Aortic valve stenosis Valvular Heart Disease Heart Valve Prosthesis Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Heart Journal Jørgensen, T H, Thyregod, H G H, Ihlemann, N, Nissen, H, Petursson, P, Kjeldsen, B J, Steinbrüchel, D A, Olsen, P S & Søndergaard, L 2021, ' Eight-year outcomes for patients with aortic valve stenosis at low surgical risk randomized to transcatheter vs. surgical aortic valve replacement ', European Heart Journal, vol. 42, no. 30, pp. 2912-2919 . https://doi.org/10.1093/eurheartj/ehab375 |
| ISSN: | 1522-9645 0195-668X |
| Popis: | Aims The aims of the study were to compare clinical outcomes and valve durability after 8 years of follow-up in patients with symptomatic severe aortic valve stenosis at low surgical risk treated with either transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR). Methods and results In the NOTION trial, patients with symptomatic severe aortic valve stenosis were randomized to TAVI or SAVR. Clinical status, echocardiography, structural valve deterioration, and failure were assessed using standardized definitions. In total, 280 patients were randomized to TAVI (n = 145) or SAVR (n = 135). Baseline characteristics were similar, including mean age of 79.1 ± 4.8 years and a mean STS score of 3.0 ± 1.7%. At 8-year follow-up, the estimated risk of the composite outcome of all-cause mortality, stroke, or myocardial infarction was 54.5% after TAVI and 54.8% after SAVR (P = 0.94). The estimated risks for all-cause mortality (51.8% vs. 52.6%; P = 0.90), stroke (8.3% vs. 9.1%; P = 0.90), or myocardial infarction (6.2% vs. 3.8%; P = 0.33) were similar after TAVI and SAVR. The risk of structural valve deterioration was lower after TAVI than after SAVR (13.9% vs. 28.3%; P = 0.0017), whereas the risk of bioprosthetic valve failure was similar (8.7% vs. 10.5%; P = 0.61). Conclusions In patients with severe aortic valve stenosis at low surgical risk randomized to TAVI or SAVR, there were no significant differences in the risk for all-cause mortality, stroke, or myocardial infarction, as well as the risk of bioprosthetic valve failure after 8 years of follow-up. Clinical trial registration URL: http://www.ClinicalTrials.gov. Unique identifier: NCT01057173. Graphical Abstract Clinical and aortic bioprosthetic valve failure 8 years after transcatheter and surgical aortic valve replacement. CI, confidence interval; HR, hazard ratio. |
| Databáze: | OpenAIRE |
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