| Autor: |
Rainer, Hoffmann, Bader, Almutairi, Ralf, Herpertz, Sara, Lotfipour, Robert, Stöhr, Omer, Aktug, Kathrin, Brehmer, Emilia, Stegemann, Rüdiger, Autschbach, Nikolaus, Marx, Guido, Dohmen |
| Rok vydání: |
2013 |
| Předmět: |
|
| Zdroj: |
The Journal of heart valve disease. 22(1) |
| ISSN: |
0966-8519 |
| Popis: |
Transcatheter aortic valve implantation (TAVI) has become a therapeutic option for the treatment of high-risk or inoperable patients with symptomatic severe aortic stenosis. The study aim was to compare the two-year mortality of high-risk or inoperable patients treated by TAVI compared to medical therapy, in a single-center setting.A total of 135 consecutive patients (58 males, 77 females; mean age 80 +/- 6 years; logistic EuroSCORE 21 +/- 13%) who had undergone TAVI was compared to 135 patients (60 males, 75 females; mean age 79 +/- 3 years; logistic EuroSCORE 21 +/- 19%) who had undergone medical treatment before TAVI became available. The one- and two-year follow up mortalities were recorded for each group. In the TAVI group, the patient characteristics were analyzed for predictors of mortality.Sixteen patients (12%) in the TAVI group and 10 (7%) in the medically treated group died within 30 days of intervention or presentation (p = 0.303). At the one-year follow up, 28 TAVI patients (21%) and 69 medically treated patients (41%) died (p0.001). At the two-year follow up, 41 TAVI patients (30%) and 80 medically treated patients (59%) died (p0.001). Log-rank analysis demonstrated a significant survival benefit after TAVI compared to medical treatment during the total follow up period. Univariate predictors of death at the two-year follow up included medical therapy, logistic EuroSCORE, and pulmonary hypertension. Medical therapy remained the only independent predictor of two-year mortality in a multivariate analysis (OR 3.343; 95% CI 2.021-6.234, p0.001).In high-surgical risk or inoperable symptomatic aortic stenosis patients, the one- and two-year follow up mortalities of patients treated with TAVI was significantly lower than after medical therapy. Predictors of mortality, in addition to treatment strategy, were pulmonary hypertension and EuroSCORE. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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