Minimally invasive surgical aortic valve replacement versus transfemoral transcatheter aortic valve implantation in low-risk octogenarians : Observational, retrospective and single-center study.
Wien Klin Wochenschr
; 135(23-24): 703-711, 2023 Dec.
Article
em En
| MEDLINE
| ID: mdl-36239806
ABSTRACT
BACKGROUND:
The aim of this study was to compare short-term and mid-term outcomes in low-risk octogenarian population treated with transfemoral transcatheter aortic valve implantation (tf-TAVI) or minimally invasive aortic valve replacement (mini-AVR) for severe aortic stenosis.METHODS:
In this single-center, retrospective cohort study we gathered data on low-risk (Society of Thoracic Surgeons [STS] scoreâ¯< 4%) octogenarians before and after tf-TAVI and mini-AVR performed between January 2013 and May 2019; follow-up was completed in May 2022. Short-term outcomes were hospital length of stay, in-hospital all-cause mortality and other major postoperative outcomes. Mid-term clinical outcomes were 1year and 3year all-cause mortality. Propensity score-based matching was performed.RESULTS:
In total 106 patients were matched, resulting in 53 pairs. In-hospital complications were similar between the matched groups of patients with the exception of mild and moderate paravalvular leak (mini-AVR vs. tf-TAVI mild PVL 3.8% vs. 45.3%, pâ¯< 0.001; moderate PVL 0% vs. 3.8%, pâ¯= 0.4952) and of postprocedural acute kidney injury that was more frequent in mini-AVR group (mini-AVR vs. tf-TAVI 22.6% vs. 5.7%; pâ¯= 0.023). Hospital length of stay (pâ¯= 0.239) and in-hospital mortality (pâ¯= 0.495) did not differ between groups. The 1-year and 3year all-cause mortality Kaplan-Meier estimates were similar between mini-AVR and tf-TAVI.CONCLUSION:
In the present study on low-risk octogenarians, transfemoral TAVI and minimally invasive AVR showed comparable short-term and mid-term results. Both procedures are deemed safe and effective. Larger RCTs will be required to determine which low-risk patients will benefit most from TAVI.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Estenose da Valva Aórtica
/
Implante de Prótese de Valva Cardíaca
/
Substituição da Valva Aórtica Transcateter
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Aged80
/
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article