Contemporary short-term outcomes of surgery for aortic stenosis: transcatheter vs. surgical aortic valve replacement
Objectives This study aimed to compare the short-term outcomes of transcatheter and surgical aortic valve replacements (TAVR and SAVR) in high-, intermediate-, and low-preoperative risk patients. Methods A total of 454 patients who underwent TAVR or SAVR were included. Patients were categorized into...
Ausführliche Beschreibung
Autor*in: |
Saito, Shunsuke [verfasserIn] |
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E-Artikel |
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Sprache: |
Englisch |
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2021 |
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Anmerkung: |
© The Author(s) 2021 |
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Übergeordnetes Werk: |
Enthalten in: The Japanese journal of thoracic and cardiovascular surgery - Tōkyō : Springer Japan, 1998, 70(2021), 2 vom: 22. Juni, Seite 124-131 |
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Übergeordnetes Werk: |
volume:70 ; year:2021 ; number:2 ; day:22 ; month:06 ; pages:124-131 |
Links: |
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DOI / URN: |
10.1007/s11748-021-01672-8 |
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Katalog-ID: |
SPR046163670 |
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520 | |a Objectives This study aimed to compare the short-term outcomes of transcatheter and surgical aortic valve replacements (TAVR and SAVR) in high-, intermediate-, and low-preoperative risk patients. Methods A total of 454 patients who underwent TAVR or SAVR were included. Patients were categorized into high-, intermediate-, and low-risk according to the Society of Thoracic Surgery-Predicted Risk of Mortality score and clinical outcomes were compared between TAVR and SAVR groups. Results TAVR was less invasive, with less bleeding and transfusion (p < 0.001), less frequent new-onset atrial fibrillation (p < 0.001), and shorter intensive care unit stay (p < 0.001). Furthermore, transcatheter valves performed better than surgical valves, with lower peak velocity (p = 0.003) and pressure gradient (p < 0.001) and higher effective orifice area index (p < 0.001). The clinical outcomes of TAVR were comparable to or even superior to those of SAVR in high- and intermediate-risk patients. In low-risk patients, the 1- and 2-year mortality rates were 6.3% and 12.1%, respectively, in the TAVR group and 0% and 0.9%, respectively, in the SAVR group (p < 0.001). Mild or greater paravalvular leakage was a risk factor for mortality (hazard ratio 35.78; p < 0.001). Conclusions TAVR was superior to SAVR in the sense of less invasiveness and valvular function. However, the indication of TAVR in low-risk patients should be carefully discussed, because paravalvular leakage was a risk factor for short-term mortality. | ||
650 | 4 | |a Aortic stenosis |7 (dpeaa)DE-He213 | |
650 | 4 | |a Transcatheter aortic valve replacement |7 (dpeaa)DE-He213 | |
650 | 4 | |a Surgical aortic valve replacement |7 (dpeaa)DE-He213 | |
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700 | 1 | |a Tezuka, Masahiro |4 aut | |
700 | 1 | |a Takei, Yusuke |4 aut | |
700 | 1 | |a Tsuchiya, Go |4 aut | |
700 | 1 | |a Ogata, Koji |4 aut | |
700 | 1 | |a Monta, Osamu |4 aut | |
700 | 1 | |a Shibasaki, Ikuko |4 aut | |
700 | 1 | |a Tsutsumi, Yasushi |4 aut | |
700 | 1 | |a Fukuda, Hirotsugu |4 aut | |
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10.1007/s11748-021-01672-8 doi (DE-627)SPR046163670 (SPR)s11748-021-01672-8-e DE-627 ger DE-627 rakwb eng Saito, Shunsuke verfasserin (orcid)0000-0002-0829-2891 aut Contemporary short-term outcomes of surgery for aortic stenosis: transcatheter vs. surgical aortic valve replacement 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2021 Objectives This study aimed to compare the short-term outcomes of transcatheter and surgical aortic valve replacements (TAVR and SAVR) in high-, intermediate-, and low-preoperative risk patients. Methods A total of 454 patients who underwent TAVR or SAVR were included. Patients were categorized into high-, intermediate-, and low-risk according to the Society of Thoracic Surgery-Predicted Risk of Mortality score and clinical outcomes were compared between TAVR and SAVR groups. Results TAVR was less invasive, with less bleeding and transfusion (p < 0.001), less frequent new-onset atrial fibrillation (p < 0.001), and shorter intensive care unit stay (p < 0.001). Furthermore, transcatheter valves performed better than surgical valves, with lower peak velocity (p = 0.003) and pressure gradient (p < 0.001) and higher effective orifice area index (p < 0.001). The clinical outcomes of TAVR were comparable to or even superior to those of SAVR in high- and intermediate-risk patients. In low-risk patients, the 1- and 2-year mortality rates were 6.3% and 12.1%, respectively, in the TAVR group and 0% and 0.9%, respectively, in the SAVR group (p < 0.001). Mild or greater paravalvular leakage was a risk factor for mortality (hazard ratio 35.78; p < 0.001). Conclusions TAVR was superior to SAVR in the sense of less invasiveness and valvular function. However, the indication of TAVR in low-risk patients should be carefully discussed, because paravalvular leakage was a risk factor for short-term mortality. Aortic stenosis (dpeaa)DE-He213 Transcatheter aortic valve replacement (dpeaa)DE-He213 Surgical aortic valve replacement (dpeaa)DE-He213 Sairenchi, Toshimi aut Tezuka, Masahiro aut Takei, Yusuke aut Tsuchiya, Go aut Ogata, Koji aut Monta, Osamu aut Shibasaki, Ikuko aut Tsutsumi, Yasushi aut Fukuda, Hirotsugu aut Enthalten in The Japanese journal of thoracic and cardiovascular surgery Tōkyō : Springer Japan, 1998 70(2021), 2 vom: 22. Juni, Seite 124-131 (DE-627)539545104 (DE-600)2381600-4 1863-2092 nnns volume:70 year:2021 number:2 day:22 month:06 pages:124-131 https://dx.doi.org/10.1007/s11748-021-01672-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_120 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 AR 70 2021 2 22 06 124-131 |
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10.1007/s11748-021-01672-8 doi (DE-627)SPR046163670 (SPR)s11748-021-01672-8-e DE-627 ger DE-627 rakwb eng Saito, Shunsuke verfasserin (orcid)0000-0002-0829-2891 aut Contemporary short-term outcomes of surgery for aortic stenosis: transcatheter vs. surgical aortic valve replacement 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2021 Objectives This study aimed to compare the short-term outcomes of transcatheter and surgical aortic valve replacements (TAVR and SAVR) in high-, intermediate-, and low-preoperative risk patients. Methods A total of 454 patients who underwent TAVR or SAVR were included. Patients were categorized into high-, intermediate-, and low-risk according to the Society of Thoracic Surgery-Predicted Risk of Mortality score and clinical outcomes were compared between TAVR and SAVR groups. Results TAVR was less invasive, with less bleeding and transfusion (p < 0.001), less frequent new-onset atrial fibrillation (p < 0.001), and shorter intensive care unit stay (p < 0.001). Furthermore, transcatheter valves performed better than surgical valves, with lower peak velocity (p = 0.003) and pressure gradient (p < 0.001) and higher effective orifice area index (p < 0.001). The clinical outcomes of TAVR were comparable to or even superior to those of SAVR in high- and intermediate-risk patients. In low-risk patients, the 1- and 2-year mortality rates were 6.3% and 12.1%, respectively, in the TAVR group and 0% and 0.9%, respectively, in the SAVR group (p < 0.001). Mild or greater paravalvular leakage was a risk factor for mortality (hazard ratio 35.78; p < 0.001). Conclusions TAVR was superior to SAVR in the sense of less invasiveness and valvular function. However, the indication of TAVR in low-risk patients should be carefully discussed, because paravalvular leakage was a risk factor for short-term mortality. Aortic stenosis (dpeaa)DE-He213 Transcatheter aortic valve replacement (dpeaa)DE-He213 Surgical aortic valve replacement (dpeaa)DE-He213 Sairenchi, Toshimi aut Tezuka, Masahiro aut Takei, Yusuke aut Tsuchiya, Go aut Ogata, Koji aut Monta, Osamu aut Shibasaki, Ikuko aut Tsutsumi, Yasushi aut Fukuda, Hirotsugu aut Enthalten in The Japanese journal of thoracic and cardiovascular surgery Tōkyō : Springer Japan, 1998 70(2021), 2 vom: 22. Juni, Seite 124-131 (DE-627)539545104 (DE-600)2381600-4 1863-2092 nnns volume:70 year:2021 number:2 day:22 month:06 pages:124-131 https://dx.doi.org/10.1007/s11748-021-01672-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_120 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 AR 70 2021 2 22 06 124-131 |
allfields_unstemmed |
10.1007/s11748-021-01672-8 doi (DE-627)SPR046163670 (SPR)s11748-021-01672-8-e DE-627 ger DE-627 rakwb eng Saito, Shunsuke verfasserin (orcid)0000-0002-0829-2891 aut Contemporary short-term outcomes of surgery for aortic stenosis: transcatheter vs. surgical aortic valve replacement 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2021 Objectives This study aimed to compare the short-term outcomes of transcatheter and surgical aortic valve replacements (TAVR and SAVR) in high-, intermediate-, and low-preoperative risk patients. Methods A total of 454 patients who underwent TAVR or SAVR were included. Patients were categorized into high-, intermediate-, and low-risk according to the Society of Thoracic Surgery-Predicted Risk of Mortality score and clinical outcomes were compared between TAVR and SAVR groups. Results TAVR was less invasive, with less bleeding and transfusion (p < 0.001), less frequent new-onset atrial fibrillation (p < 0.001), and shorter intensive care unit stay (p < 0.001). Furthermore, transcatheter valves performed better than surgical valves, with lower peak velocity (p = 0.003) and pressure gradient (p < 0.001) and higher effective orifice area index (p < 0.001). The clinical outcomes of TAVR were comparable to or even superior to those of SAVR in high- and intermediate-risk patients. In low-risk patients, the 1- and 2-year mortality rates were 6.3% and 12.1%, respectively, in the TAVR group and 0% and 0.9%, respectively, in the SAVR group (p < 0.001). Mild or greater paravalvular leakage was a risk factor for mortality (hazard ratio 35.78; p < 0.001). Conclusions TAVR was superior to SAVR in the sense of less invasiveness and valvular function. However, the indication of TAVR in low-risk patients should be carefully discussed, because paravalvular leakage was a risk factor for short-term mortality. Aortic stenosis (dpeaa)DE-He213 Transcatheter aortic valve replacement (dpeaa)DE-He213 Surgical aortic valve replacement (dpeaa)DE-He213 Sairenchi, Toshimi aut Tezuka, Masahiro aut Takei, Yusuke aut Tsuchiya, Go aut Ogata, Koji aut Monta, Osamu aut Shibasaki, Ikuko aut Tsutsumi, Yasushi aut Fukuda, Hirotsugu aut Enthalten in The Japanese journal of thoracic and cardiovascular surgery Tōkyō : Springer Japan, 1998 70(2021), 2 vom: 22. Juni, Seite 124-131 (DE-627)539545104 (DE-600)2381600-4 1863-2092 nnns volume:70 year:2021 number:2 day:22 month:06 pages:124-131 https://dx.doi.org/10.1007/s11748-021-01672-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_120 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 AR 70 2021 2 22 06 124-131 |
allfieldsGer |
10.1007/s11748-021-01672-8 doi (DE-627)SPR046163670 (SPR)s11748-021-01672-8-e DE-627 ger DE-627 rakwb eng Saito, Shunsuke verfasserin (orcid)0000-0002-0829-2891 aut Contemporary short-term outcomes of surgery for aortic stenosis: transcatheter vs. surgical aortic valve replacement 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2021 Objectives This study aimed to compare the short-term outcomes of transcatheter and surgical aortic valve replacements (TAVR and SAVR) in high-, intermediate-, and low-preoperative risk patients. Methods A total of 454 patients who underwent TAVR or SAVR were included. Patients were categorized into high-, intermediate-, and low-risk according to the Society of Thoracic Surgery-Predicted Risk of Mortality score and clinical outcomes were compared between TAVR and SAVR groups. Results TAVR was less invasive, with less bleeding and transfusion (p < 0.001), less frequent new-onset atrial fibrillation (p < 0.001), and shorter intensive care unit stay (p < 0.001). Furthermore, transcatheter valves performed better than surgical valves, with lower peak velocity (p = 0.003) and pressure gradient (p < 0.001) and higher effective orifice area index (p < 0.001). The clinical outcomes of TAVR were comparable to or even superior to those of SAVR in high- and intermediate-risk patients. In low-risk patients, the 1- and 2-year mortality rates were 6.3% and 12.1%, respectively, in the TAVR group and 0% and 0.9%, respectively, in the SAVR group (p < 0.001). Mild or greater paravalvular leakage was a risk factor for mortality (hazard ratio 35.78; p < 0.001). Conclusions TAVR was superior to SAVR in the sense of less invasiveness and valvular function. However, the indication of TAVR in low-risk patients should be carefully discussed, because paravalvular leakage was a risk factor for short-term mortality. Aortic stenosis (dpeaa)DE-He213 Transcatheter aortic valve replacement (dpeaa)DE-He213 Surgical aortic valve replacement (dpeaa)DE-He213 Sairenchi, Toshimi aut Tezuka, Masahiro aut Takei, Yusuke aut Tsuchiya, Go aut Ogata, Koji aut Monta, Osamu aut Shibasaki, Ikuko aut Tsutsumi, Yasushi aut Fukuda, Hirotsugu aut Enthalten in The Japanese journal of thoracic and cardiovascular surgery Tōkyō : Springer Japan, 1998 70(2021), 2 vom: 22. Juni, Seite 124-131 (DE-627)539545104 (DE-600)2381600-4 1863-2092 nnns volume:70 year:2021 number:2 day:22 month:06 pages:124-131 https://dx.doi.org/10.1007/s11748-021-01672-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_120 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 AR 70 2021 2 22 06 124-131 |
allfieldsSound |
10.1007/s11748-021-01672-8 doi (DE-627)SPR046163670 (SPR)s11748-021-01672-8-e DE-627 ger DE-627 rakwb eng Saito, Shunsuke verfasserin (orcid)0000-0002-0829-2891 aut Contemporary short-term outcomes of surgery for aortic stenosis: transcatheter vs. surgical aortic valve replacement 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2021 Objectives This study aimed to compare the short-term outcomes of transcatheter and surgical aortic valve replacements (TAVR and SAVR) in high-, intermediate-, and low-preoperative risk patients. Methods A total of 454 patients who underwent TAVR or SAVR were included. Patients were categorized into high-, intermediate-, and low-risk according to the Society of Thoracic Surgery-Predicted Risk of Mortality score and clinical outcomes were compared between TAVR and SAVR groups. Results TAVR was less invasive, with less bleeding and transfusion (p < 0.001), less frequent new-onset atrial fibrillation (p < 0.001), and shorter intensive care unit stay (p < 0.001). Furthermore, transcatheter valves performed better than surgical valves, with lower peak velocity (p = 0.003) and pressure gradient (p < 0.001) and higher effective orifice area index (p < 0.001). The clinical outcomes of TAVR were comparable to or even superior to those of SAVR in high- and intermediate-risk patients. In low-risk patients, the 1- and 2-year mortality rates were 6.3% and 12.1%, respectively, in the TAVR group and 0% and 0.9%, respectively, in the SAVR group (p < 0.001). Mild or greater paravalvular leakage was a risk factor for mortality (hazard ratio 35.78; p < 0.001). Conclusions TAVR was superior to SAVR in the sense of less invasiveness and valvular function. However, the indication of TAVR in low-risk patients should be carefully discussed, because paravalvular leakage was a risk factor for short-term mortality. Aortic stenosis (dpeaa)DE-He213 Transcatheter aortic valve replacement (dpeaa)DE-He213 Surgical aortic valve replacement (dpeaa)DE-He213 Sairenchi, Toshimi aut Tezuka, Masahiro aut Takei, Yusuke aut Tsuchiya, Go aut Ogata, Koji aut Monta, Osamu aut Shibasaki, Ikuko aut Tsutsumi, Yasushi aut Fukuda, Hirotsugu aut Enthalten in The Japanese journal of thoracic and cardiovascular surgery Tōkyō : Springer Japan, 1998 70(2021), 2 vom: 22. Juni, Seite 124-131 (DE-627)539545104 (DE-600)2381600-4 1863-2092 nnns volume:70 year:2021 number:2 day:22 month:06 pages:124-131 https://dx.doi.org/10.1007/s11748-021-01672-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_120 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 AR 70 2021 2 22 06 124-131 |
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Methods A total of 454 patients who underwent TAVR or SAVR were included. Patients were categorized into high-, intermediate-, and low-risk according to the Society of Thoracic Surgery-Predicted Risk of Mortality score and clinical outcomes were compared between TAVR and SAVR groups. Results TAVR was less invasive, with less bleeding and transfusion (p < 0.001), less frequent new-onset atrial fibrillation (p < 0.001), and shorter intensive care unit stay (p < 0.001). Furthermore, transcatheter valves performed better than surgical valves, with lower peak velocity (p = 0.003) and pressure gradient (p < 0.001) and higher effective orifice area index (p < 0.001). The clinical outcomes of TAVR were comparable to or even superior to those of SAVR in high- and intermediate-risk patients. In low-risk patients, the 1- and 2-year mortality rates were 6.3% and 12.1%, respectively, in the TAVR group and 0% and 0.9%, respectively, in the SAVR group (p < 0.001). Mild or greater paravalvular leakage was a risk factor for mortality (hazard ratio 35.78; p < 0.001). Conclusions TAVR was superior to SAVR in the sense of less invasiveness and valvular function. 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Saito, Shunsuke |
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Contemporary short-term outcomes of surgery for aortic stenosis: transcatheter vs. surgical aortic valve replacement Aortic stenosis (dpeaa)DE-He213 Transcatheter aortic valve replacement (dpeaa)DE-He213 Surgical aortic valve replacement (dpeaa)DE-He213 |
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Saito, Shunsuke Sairenchi, Toshimi Tezuka, Masahiro Takei, Yusuke Tsuchiya, Go Ogata, Koji Monta, Osamu Shibasaki, Ikuko Tsutsumi, Yasushi Fukuda, Hirotsugu |
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contemporary short-term outcomes of surgery for aortic stenosis: transcatheter vs. surgical aortic valve replacement |
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Contemporary short-term outcomes of surgery for aortic stenosis: transcatheter vs. surgical aortic valve replacement |
abstract |
Objectives This study aimed to compare the short-term outcomes of transcatheter and surgical aortic valve replacements (TAVR and SAVR) in high-, intermediate-, and low-preoperative risk patients. Methods A total of 454 patients who underwent TAVR or SAVR were included. Patients were categorized into high-, intermediate-, and low-risk according to the Society of Thoracic Surgery-Predicted Risk of Mortality score and clinical outcomes were compared between TAVR and SAVR groups. Results TAVR was less invasive, with less bleeding and transfusion (p < 0.001), less frequent new-onset atrial fibrillation (p < 0.001), and shorter intensive care unit stay (p < 0.001). Furthermore, transcatheter valves performed better than surgical valves, with lower peak velocity (p = 0.003) and pressure gradient (p < 0.001) and higher effective orifice area index (p < 0.001). The clinical outcomes of TAVR were comparable to or even superior to those of SAVR in high- and intermediate-risk patients. In low-risk patients, the 1- and 2-year mortality rates were 6.3% and 12.1%, respectively, in the TAVR group and 0% and 0.9%, respectively, in the SAVR group (p < 0.001). Mild or greater paravalvular leakage was a risk factor for mortality (hazard ratio 35.78; p < 0.001). Conclusions TAVR was superior to SAVR in the sense of less invasiveness and valvular function. However, the indication of TAVR in low-risk patients should be carefully discussed, because paravalvular leakage was a risk factor for short-term mortality. © The Author(s) 2021 |
abstractGer |
Objectives This study aimed to compare the short-term outcomes of transcatheter and surgical aortic valve replacements (TAVR and SAVR) in high-, intermediate-, and low-preoperative risk patients. Methods A total of 454 patients who underwent TAVR or SAVR were included. Patients were categorized into high-, intermediate-, and low-risk according to the Society of Thoracic Surgery-Predicted Risk of Mortality score and clinical outcomes were compared between TAVR and SAVR groups. Results TAVR was less invasive, with less bleeding and transfusion (p < 0.001), less frequent new-onset atrial fibrillation (p < 0.001), and shorter intensive care unit stay (p < 0.001). Furthermore, transcatheter valves performed better than surgical valves, with lower peak velocity (p = 0.003) and pressure gradient (p < 0.001) and higher effective orifice area index (p < 0.001). The clinical outcomes of TAVR were comparable to or even superior to those of SAVR in high- and intermediate-risk patients. In low-risk patients, the 1- and 2-year mortality rates were 6.3% and 12.1%, respectively, in the TAVR group and 0% and 0.9%, respectively, in the SAVR group (p < 0.001). Mild or greater paravalvular leakage was a risk factor for mortality (hazard ratio 35.78; p < 0.001). Conclusions TAVR was superior to SAVR in the sense of less invasiveness and valvular function. However, the indication of TAVR in low-risk patients should be carefully discussed, because paravalvular leakage was a risk factor for short-term mortality. © The Author(s) 2021 |
abstract_unstemmed |
Objectives This study aimed to compare the short-term outcomes of transcatheter and surgical aortic valve replacements (TAVR and SAVR) in high-, intermediate-, and low-preoperative risk patients. Methods A total of 454 patients who underwent TAVR or SAVR were included. Patients were categorized into high-, intermediate-, and low-risk according to the Society of Thoracic Surgery-Predicted Risk of Mortality score and clinical outcomes were compared between TAVR and SAVR groups. Results TAVR was less invasive, with less bleeding and transfusion (p < 0.001), less frequent new-onset atrial fibrillation (p < 0.001), and shorter intensive care unit stay (p < 0.001). Furthermore, transcatheter valves performed better than surgical valves, with lower peak velocity (p = 0.003) and pressure gradient (p < 0.001) and higher effective orifice area index (p < 0.001). The clinical outcomes of TAVR were comparable to or even superior to those of SAVR in high- and intermediate-risk patients. In low-risk patients, the 1- and 2-year mortality rates were 6.3% and 12.1%, respectively, in the TAVR group and 0% and 0.9%, respectively, in the SAVR group (p < 0.001). Mild or greater paravalvular leakage was a risk factor for mortality (hazard ratio 35.78; p < 0.001). Conclusions TAVR was superior to SAVR in the sense of less invasiveness and valvular function. However, the indication of TAVR in low-risk patients should be carefully discussed, because paravalvular leakage was a risk factor for short-term mortality. © The Author(s) 2021 |
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Contemporary short-term outcomes of surgery for aortic stenosis: transcatheter vs. surgical aortic valve replacement |
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Mild or greater paravalvular leakage was a risk factor for mortality (hazard ratio 35.78; p < 0.001). Conclusions TAVR was superior to SAVR in the sense of less invasiveness and valvular function. 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