The German Aortic Valve Registry (GARY): in-hospital outcome

Abstract

BackgroundAortic stenosis is a frequent valvular disease especially in elderly patients. Catheter-based valve implantation has emerged as a valuable treatment approach for these patients being either at very high risk for conventional surgery or even deemed inoperable. The German Aortic Valve Registry (GARY) provides data on conventional and catheter-based aortic procedures on an all-comers basis.Methods and resultsA total of 13 860 consecutive patients undergoing repair for aortic valve disease [conventional surgery and transvascular (TV) or transapical (TA) catheter-based techniques] have been enrolled in this registry during 2011 and baseline, procedural, and outcome data have been acquired. The registry summarizes the results of 6523 conventional aortic valve replacements without (AVR) and 3464 with concomitant coronary bypass surgery (AVR + CABG) as well as 2695 TV AVI and 1181 TA interventions (TA AVI). Patients undergoing catheter-based techniques were significantly older and had higher risk profiles. The stroke rate was low in all groups with 1.3% (AVR), 1.9% (AVR + CABG), 1.7% (TV AVI), and 2.3% (TA AVI). The in-hospital mortality was 2.1% (AVR) and 4.5% (AVR + CABG) for patients undergoing conventional surgery, and 5.1% (TV AVI) and AVI 7.7% (TA AVI).ConclusionThe in-hospital outcome results of this registry show that conventional surgery yields excellent results in all risk groups and that catheter-based aortic valve replacements is an alternative to conventional surgery in high risk and elderly patients.

Comparison of dual antiplatelet therapy versus oral anticoagulation following transcatheter aortic valve replacement: A retrospective single-center registry analysis

“…In the present study, the incidence of all-cause mortality, stroke and MI at 30 days was comparable to results previously published in prospective landmark trials as well as nationwide registries [16][17][18][19][20]. Post interventional DAPT or OAC resulted in similar rates of MI, stroke and all-cause mortality up to 6 months after TAVR thereby underscoring the efficacy of both therapeutic regimens.…”

Transfemoral Aortic Valve Implantation of Edwards SAPIEN XT Without Predilatation Is Feasible

“…The outcome of TAVI procedures has improved dramatically in the last decade. 1,2 Nonetheless, the complication rate is still rather high. Several complications can be attributed at least in part to balloon aortic valvuloplasty, which is typically performed prior to the valve implantation, especially with the balloon-expandable transfemoral Edwards SAPIEN prosthesis (Edwards Lifesciences Corp., Irvine, CA).…”

Intraoperative paravalvular leakage after sutureless aortic valve replacement corrected with secondary balloon dilatation -A case report-

“…A case of leakage caused by postoperative stent distortion has been reported, and stent fatigue and creep have been proposed as potential concerns [3]. Nonetheless, the reported incidence of early and late postoperative paravalvular leakage ranges from 2% to 4%, which is far lower than that of TAVI and comparable to that of conventional aortic valve replacement [7,8].…”