The aged and the ill: A decade of surgical aortic valve replacement outcomes

Tsai, Lillian L.; Jensen, Hanna; Thourani, Vinod H.

doi:10.1016/j.jtcvs.2015.06.016

Cited by 1 publication

(2 citation statements)

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“…In an analysis from the U.S. National Registry in 2015, a CVE incidence of 2.9% was reported after CABG þ AVR perioperatively. 22 The risk increased with age, with an incidence of 1.3% in patients younger than70 years and 3.2% in those older than 85 years. The incidence of CVEs after TAVI ranged from 2.7 to 5.5% at 30 days in most TAVI RCTs.…”

Section: Discussionmentioning

confidence: 99%

“…This incidence increased with age, with 7.4% in patients older than 85 years. 22 On the other hand, the GARY registry showed in 2015 an inhospital mortality of 2.3% after TF-TAVI and 3.7% after TA-TAVI in a high-risk cohort with an average age of 80 years. 6 A more recent evaluation in 2020 showed a significant reduction in TAVI mortality at average of all access routes of 1.6%.…”

Section: Discussionmentioning

confidence: 99%

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Surgical versus Interventional Treatment of Concomitant Aortic Valve Stenosis and Coronary Artery Disease

Elderia

Gerfer

Eghbalzadeh

et al. 2022

Thorac Cardiovasc Surg

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Coronary artery disease is frequently diagnosed in patients with aortic valve stenosis. Treatment options include surgical and interventional approaches. We therefore analyzed short-term outcomes of patients undergoing either coronary artery bypass grafting with simultaneous aortic valve replacement (CABG+AVR) or staged percutaneous coronary intervention and transcatheter aortic valve implantation (PCI+TAVI). Methods: From all patients treated since 2017 we retrospectively identified 237 patients undergoing TAVI within 6 months after PCI and 241 patients undergoing combined CABG+AVR surgery. Propensity score matching was performed resulting in 101 matched pairs. Results: patients in the CABG+AVR group were younger compared to patients in the PCI+TAVI group (71.9±4.9 vs. 81.4±3.6 years; p<0.001). The overall mortality at 30 days before matching was higher after CABG+AVR than after PCI+TAVI (7.8% vs. 2.1%; p=0.012). The paired cohort was balanced for both groups regarding demographic variables and the risk profile (age: 77.2±3.7 vs.78.5±2.7 years; p=0.141) and Euro Score II (6.2% vs. 7.6%; p=0.297). At 30 days, mortality was 4.9% in the CABG+AVR group and 1,0% in the PCI+TAVI group and (p=0.099). Re-thoracotomy was necessary in 7.9% in the CABG+AVR, while conversion to open heart surgery was necessary in 2 % in the PCI+TAVI group. The need for new pacemaker was lower after CABG+AVR than after PCI+TAVI (4.1% vs.6.9%; p=0.010). No paravalvular leak was noted in the CABG+AVR group, while the incidence of moderate to severe PVL after PCI+TAVI was 4.9 %; (p=0.027). Conclusion: A staged PCI+TAVI comprises a short-term survival advantage for management of CAD and AS. Long-term Trials are warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%