The impact of transcatheter aortic valve implantation on patients' profiles and outcomes of aortic valve surgery programmes: a multi-institutional appraisal

Author： D'Onofrio Augusto Alfieri Ottavio R. Cioni Micaela Alamanni Francesco Fusari Melissa Tarzia Vincenzo Rizzoli Giulio Gerosa Gino

Publisher： Oxford University Press

ISSN： 1569-9293

Source： Interactive CardioVascular and Thoracic Surgery, Vol.16, Iss.5, 2013-05, pp. : 608-611

Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.

Previous Menu Next

Abstract

OBJECTIVESThe aim of this retrospective multicenter study was to assess how the development of transcatheter aortic valve implantation (TAVI) influenced the characteristics and outcomes of patients undergoing aortic valve procedures.METHODSWe reviewed 1395 patients who underwent isolated surgical aortic valve replacement (SAVR) or TAVI in three centres with a high-volume TAVI programme. Patients were divided into two groups: Pre-TAVI (395 patients, 28.3) and Post-TAVI (1000 patients, 71.7) operated on before and after the introduction of TAVI into clinical practice. We evaluated age, logistic EuroSCORE I (LES) and hospital mortality according to time periods and the procedure performed, whether SAVR or TAVI.RESULTSPost-TAVI patients were older (78.2 7.8 vs 76.8 6.7 years; P 0.002) and with a significantly higher LES (17.8 14.7 vs 9.1 9.2; P < 0.001) than Pre-TAVI patients. Hospital mortality was not significantly different between groups (Pre-TAVI vs Post-TAVI: 2 vs 3.4; P 0.17). Of the 1000 Post-TAVI patients, 605 (60.5) underwent TAVI and 395 (39.5), SAVR. Patients undergoing TAVI were older (79.9 7.1 vs 75.5 9.2 years; P < 0.001) and with a higher LES (22.9 15.3 vs 9.7 9.3; P < 0.001) than Post-TAVI SAVR patients, but their hospital mortality was similar (3.9 vs 2.5; P 0.22). LES was similar between Pre-TAVI and Post-TAVI SAVR patients (9.1 9.2 vs 9.7 9.3; P 0.26). Furthermore, we did not find significant differences in the overall hospital mortality between SAVR and TAVI patients: 2.3 vs 3.9, P 0.08.CONCLUSIONSThis analysis shows that the development of TAVI has caused an increase in the preoperative risk profile of patients scheduled for aortic valve procedures (SAVR or TAVI) without increasing hospital mortality.