Patients at low surgical risk as defined by the Society of Thoracic Surgeons Score undergoing isolated interventional or surgical aortic valve implantation: in-hospital data and 1-year results from the German Aortic Valve Registry (GARY)

Raffi Bekeredjian, G. Szabó, Ümniye Balaban, Sabine Bleiziffer, Timm Bauer, Stephan Ensminger, Christian Frerker, Eva Herrmann, Friedhelm Beyersdorf, Christian Hamm, Andreas Beckmann, Helge Möllmann, Matthias Karck, Hugo A. Katus, Thomas Walther

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

AIMS: Transcatheter aortic valve implantation (TAVI) has become the standard treatment for patients with severe aortic valve stenosis at high surgical risk and may be considered for patients with intermediate risk. During the last few years, an increasing number of patients with low surgical risk have been treated with TAVI. In this study, low-risk patients undergoing isolated TAVI or surgical aortic valve replacement (SAVR) were analysed using data from the German Aortic Valve Registry (GARY). METHODS AND RESULTS: All patients with a Society of Thoracic Surgeons Score of <4% undergoing TAVI or SAVR in 2014 and 2015 were evaluated. A total of 20 549 low surgical risk patients remained for further analysis, comprising 14 487 surgical patients and 6062 TAVI patients. Since TAVI patients were significantly older and had significantly more co-morbidities, a weighted propensity score model was used to compare SAVR and TAVI patients for in-hospital, 30-day, and 1-year mortality. Transcatheter aortic valve implantation patients showed a significantly higher in-hospital and 30-day survival than SAVR patients (in hospital survival TAVI vs. SAVR: 98.5% vs. 97.3%; P = 0.003; 30-day survival TAVI vs. SAVR: 98.1% vs. 97.1%; P = 0.014). At 1 year, survival rates did not differ significantly (survival TAVI vs. SAVR: 90.0% vs. 91.2%; P = 0.158). CONCLUSION: In this first GARY analysis of low-risk patients, weighted comparison showed similar 1-year survival for TAVI and SAVR and higher in-hospital survival for TAVI patients.

Original languageEnglish
Pages (from-to)1323-1330
Number of pages8
JournalEuropean heart journal
Volume40
Issue number17
DOIs
Publication statusPublished - May 1 2019

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Aortic Valve
Surgical Instruments
Registries
Survival
Transcatheter Aortic Valve Replacement
Propensity Score
Aortic Valve Stenosis
Survival Rate

Keywords

  • Low risk
  • Surgical aortic valve replacement
  • Transcatheter aortic valve implantation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Patients at low surgical risk as defined by the Society of Thoracic Surgeons Score undergoing isolated interventional or surgical aortic valve implantation : in-hospital data and 1-year results from the German Aortic Valve Registry (GARY). / Bekeredjian, Raffi; Szabó, G.; Balaban, Ümniye; Bleiziffer, Sabine; Bauer, Timm; Ensminger, Stephan; Frerker, Christian; Herrmann, Eva; Beyersdorf, Friedhelm; Hamm, Christian; Beckmann, Andreas; Möllmann, Helge; Karck, Matthias; Katus, Hugo A.; Walther, Thomas.

In: European heart journal, Vol. 40, No. 17, 01.05.2019, p. 1323-1330.

Research output: Contribution to journalArticle

Bekeredjian, R, Szabó, G, Balaban, Ü, Bleiziffer, S, Bauer, T, Ensminger, S, Frerker, C, Herrmann, E, Beyersdorf, F, Hamm, C, Beckmann, A, Möllmann, H, Karck, M, Katus, HA & Walther, T 2019, 'Patients at low surgical risk as defined by the Society of Thoracic Surgeons Score undergoing isolated interventional or surgical aortic valve implantation: in-hospital data and 1-year results from the German Aortic Valve Registry (GARY)', European heart journal, vol. 40, no. 17, pp. 1323-1330. https://doi.org/10.1093/eurheartj/ehy699
Bekeredjian, Raffi ; Szabó, G. ; Balaban, Ümniye ; Bleiziffer, Sabine ; Bauer, Timm ; Ensminger, Stephan ; Frerker, Christian ; Herrmann, Eva ; Beyersdorf, Friedhelm ; Hamm, Christian ; Beckmann, Andreas ; Möllmann, Helge ; Karck, Matthias ; Katus, Hugo A. ; Walther, Thomas. / Patients at low surgical risk as defined by the Society of Thoracic Surgeons Score undergoing isolated interventional or surgical aortic valve implantation : in-hospital data and 1-year results from the German Aortic Valve Registry (GARY). In: European heart journal. 2019 ; Vol. 40, No. 17. pp. 1323-1330.
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abstract = "AIMS: Transcatheter aortic valve implantation (TAVI) has become the standard treatment for patients with severe aortic valve stenosis at high surgical risk and may be considered for patients with intermediate risk. During the last few years, an increasing number of patients with low surgical risk have been treated with TAVI. In this study, low-risk patients undergoing isolated TAVI or surgical aortic valve replacement (SAVR) were analysed using data from the German Aortic Valve Registry (GARY). METHODS AND RESULTS: All patients with a Society of Thoracic Surgeons Score of <4{\%} undergoing TAVI or SAVR in 2014 and 2015 were evaluated. A total of 20 549 low surgical risk patients remained for further analysis, comprising 14 487 surgical patients and 6062 TAVI patients. Since TAVI patients were significantly older and had significantly more co-morbidities, a weighted propensity score model was used to compare SAVR and TAVI patients for in-hospital, 30-day, and 1-year mortality. Transcatheter aortic valve implantation patients showed a significantly higher in-hospital and 30-day survival than SAVR patients (in hospital survival TAVI vs. SAVR: 98.5{\%} vs. 97.3{\%}; P = 0.003; 30-day survival TAVI vs. SAVR: 98.1{\%} vs. 97.1{\%}; P = 0.014). At 1 year, survival rates did not differ significantly (survival TAVI vs. SAVR: 90.0{\%} vs. 91.2{\%}; P = 0.158). CONCLUSION: In this first GARY analysis of low-risk patients, weighted comparison showed similar 1-year survival for TAVI and SAVR and higher in-hospital survival for TAVI patients.",
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AU - Szabó, G.

AU - Balaban, Ümniye

AU - Bleiziffer, Sabine

AU - Bauer, Timm

AU - Ensminger, Stephan

AU - Frerker, Christian

AU - Herrmann, Eva

AU - Beyersdorf, Friedhelm

AU - Hamm, Christian

AU - Beckmann, Andreas

AU - Möllmann, Helge

AU - Karck, Matthias

AU - Katus, Hugo A.

AU - Walther, Thomas

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N2 - AIMS: Transcatheter aortic valve implantation (TAVI) has become the standard treatment for patients with severe aortic valve stenosis at high surgical risk and may be considered for patients with intermediate risk. During the last few years, an increasing number of patients with low surgical risk have been treated with TAVI. In this study, low-risk patients undergoing isolated TAVI or surgical aortic valve replacement (SAVR) were analysed using data from the German Aortic Valve Registry (GARY). METHODS AND RESULTS: All patients with a Society of Thoracic Surgeons Score of <4% undergoing TAVI or SAVR in 2014 and 2015 were evaluated. A total of 20 549 low surgical risk patients remained for further analysis, comprising 14 487 surgical patients and 6062 TAVI patients. Since TAVI patients were significantly older and had significantly more co-morbidities, a weighted propensity score model was used to compare SAVR and TAVI patients for in-hospital, 30-day, and 1-year mortality. Transcatheter aortic valve implantation patients showed a significantly higher in-hospital and 30-day survival than SAVR patients (in hospital survival TAVI vs. SAVR: 98.5% vs. 97.3%; P = 0.003; 30-day survival TAVI vs. SAVR: 98.1% vs. 97.1%; P = 0.014). At 1 year, survival rates did not differ significantly (survival TAVI vs. SAVR: 90.0% vs. 91.2%; P = 0.158). CONCLUSION: In this first GARY analysis of low-risk patients, weighted comparison showed similar 1-year survival for TAVI and SAVR and higher in-hospital survival for TAVI patients.

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