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Transcatheter versus surgical treatment for aortic stenosis : Patient selection and early outcome

Appel, Carl-Fredrik (author)
Linköpings universitet,Östergötlands Läns Landsting,Thorax-kärlkliniken i Östergötland,Kardiologi,Hälsouniversitetet
Hultkvist, Henrik (author)
Östergötlands Läns Landsting,Linköpings universitet,Thoraxkirurgi,Hälsouniversitetet,Thorax-kärlkliniken i Östergötland
Nylander, Eva (author)
Östergötlands Läns Landsting,Linköpings universitet,Klinisk fysiologi,Hälsouniversitetet,Fysiologiska kliniken US
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Ahn, Henrik Casimir (author)
Östergötlands Läns Landsting,Linköpings universitet,Thoraxkirurgi,Hälsouniversitetet,Thorax-kärlkliniken i Östergötland
Nielsen, Niels Erik (author)
Östergötlands Läns Landsting,Linköpings universitet,Kardiologi,Hälsouniversitetet,Kardiologiska kliniken US
Freter, Wolfgang (author)
Linköpings universitet,Östergötlands Läns Landsting,Thorax-kärlkliniken i Östergötland,Kardiologi,Hälsouniversitetet
Vánky, Farkas (author)
Östergötlands Läns Landsting,Linköpings universitet,Thoraxkirurgi,Hälsouniversitetet,Thorax-kärlkliniken i Östergötland
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 (creator_code:org_t)
2012-07-05
2012
English.
In: Scandinavian Cardiovascular Journal. - : Informa Healthcare. - 1401-7431 .- 1651-2006. ; 46:5, s. 301-307
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  • Journal article (peer-reviewed)
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  • Objectives. To describe short-term clinical and echocardiography outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR). To explore patient selection criteria for treatment with TAVI. Design. TAVI patients (n = 45) were matched to SAVR patients (n = 45) with respect to age within +/- 10 years, sex and systolic left ventricular function. Results. TAVI patients were older, 82 +/- 8 versus 78 +/- 5 years (p = 0.005) and they had higher logEuroSCORE, 16 +/- 11% versus 8 +/- 4% (p andlt; 0.001). There were no significant differences in 30 days mortality, stroke and myocardial infarction. TAVI patients received less erythrocyte (53% vs. 78%, p = 0.03) and thrombocyte (7% vs. 27%, p = 0.02) transfusions. Postoperative atrial fibrillation was less common (18% vs. 60%, p andlt; 0.001) in the TAVI group. Paravalvular regurgitation was more common in TAVI patients (87% vs. 0%, p andlt; 0.001) and 27% had access site complications. Aortic transvalvular velocity was 2.3 +/- 0.4 m/s versus 2.6 +/- 0.5 m/s (p = 0.002) and mean valve pressure gradient was 12 +/- 4 mmHg versus 15 +/- 5 mmHg (p = 0.01) in the TAVI and SAVR groups, respectively. Twenty-nine (64%) of the TAVI patients had logEuroSCORE andlt; 15%. Conclusions. Both TAVI and SAVR have good short term clinical outcome with excellent hemodynamic result. In clinical practice, factors other than high logEuroSCORE play an important role in patient selection for TAVI.

Keyword

transcatheter aortic valve implantation
aortic valve replacement
outcome
echocardiography
patient selection
MEDICINE
MEDICIN

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