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Comparison of Early Clinical Results of Transcatheter versus Surgical Aortic Valve Replacement in Symptomatic High Risk Severe Aortic Stenosis Patients

BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been an alternative to conventional aortic valve replacement (AVR) in old and high risk patients. The goal of this study is to compare the early outcomes of conventional AVR vs. TAVI in high risk severe AS patients. METHODS: From January...

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Autores principales: Yu, Woo Sik, Chang, Byung-Chul, Joo, Hyun Chel, Ko, Young-Guk, Lee, Sak
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society for Thoracic and Cardiovascular Surgery 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810556/
https://www.ncbi.nlm.nih.gov/pubmed/24175269
http://dx.doi.org/10.5090/kjtcs.2013.46.5.346
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author Yu, Woo Sik
Chang, Byung-Chul
Joo, Hyun Chel
Ko, Young-Guk
Lee, Sak
author_facet Yu, Woo Sik
Chang, Byung-Chul
Joo, Hyun Chel
Ko, Young-Guk
Lee, Sak
author_sort Yu, Woo Sik
collection PubMed
description BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been an alternative to conventional aortic valve replacement (AVR) in old and high risk patients. The goal of this study is to compare the early outcomes of conventional AVR vs. TAVI in high risk severe AS patients. METHODS: From January 2008 to July 2012, 44 high risk severe aortic stenosis patients underwent conventional AVR, and 15 patients underwent TAVI. We compared echocardiographic data, periprocedural complication, and survival. The mean follow-up duration was 14.5±10 months (AVR), and 6.8±3.5 months (TAVI), respectively. RESULTS: AVR group was younger (78.2±2.4 years vs. 82.2±3.0 years, p<0.001) and had lower operative risk (Euroscore: 9.4±2.7 vs. 11.0±2.0, p=0.044) than TAVI group. There was no significant difference in early mortality (11.4% vs. 13.3%, p=0.839), and 1 year survival (87.4%±5.3% vs. 83.1%±1.1%, p=0.805). There was no significant difference in postoperative functional class. There was no significant difference in periprocedural complication except vascular complication (0% [AVR] vs. 13.3% [TAVI], p=0.014). TAVI group had more moderate and severe paravalvular leakage. CONCLUSION: In this study, both groups had similar periprocedural morbidity, and mortality. However, TAVI group had more greater than moderate paravalvular leakage, which can influence long-term outcome. Since more patients are treated with TAVI even in moderate risk, careful selection of the patients and appropriate guideline need to be established.
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spelling pubmed-38105562013-10-30 Comparison of Early Clinical Results of Transcatheter versus Surgical Aortic Valve Replacement in Symptomatic High Risk Severe Aortic Stenosis Patients Yu, Woo Sik Chang, Byung-Chul Joo, Hyun Chel Ko, Young-Guk Lee, Sak Korean J Thorac Cardiovasc Surg Clinical Research BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been an alternative to conventional aortic valve replacement (AVR) in old and high risk patients. The goal of this study is to compare the early outcomes of conventional AVR vs. TAVI in high risk severe AS patients. METHODS: From January 2008 to July 2012, 44 high risk severe aortic stenosis patients underwent conventional AVR, and 15 patients underwent TAVI. We compared echocardiographic data, periprocedural complication, and survival. The mean follow-up duration was 14.5±10 months (AVR), and 6.8±3.5 months (TAVI), respectively. RESULTS: AVR group was younger (78.2±2.4 years vs. 82.2±3.0 years, p<0.001) and had lower operative risk (Euroscore: 9.4±2.7 vs. 11.0±2.0, p=0.044) than TAVI group. There was no significant difference in early mortality (11.4% vs. 13.3%, p=0.839), and 1 year survival (87.4%±5.3% vs. 83.1%±1.1%, p=0.805). There was no significant difference in postoperative functional class. There was no significant difference in periprocedural complication except vascular complication (0% [AVR] vs. 13.3% [TAVI], p=0.014). TAVI group had more moderate and severe paravalvular leakage. CONCLUSION: In this study, both groups had similar periprocedural morbidity, and mortality. However, TAVI group had more greater than moderate paravalvular leakage, which can influence long-term outcome. Since more patients are treated with TAVI even in moderate risk, careful selection of the patients and appropriate guideline need to be established. Korean Society for Thoracic and Cardiovascular Surgery 2013-10 2013-10-04 /pmc/articles/PMC3810556/ /pubmed/24175269 http://dx.doi.org/10.5090/kjtcs.2013.46.5.346 Text en © The Korean Society for Thoracic and Cardiovascular Surgery. 2013. All right reserved. http://creativecommons.org/licenses/by-nc/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Research
Yu, Woo Sik
Chang, Byung-Chul
Joo, Hyun Chel
Ko, Young-Guk
Lee, Sak
Comparison of Early Clinical Results of Transcatheter versus Surgical Aortic Valve Replacement in Symptomatic High Risk Severe Aortic Stenosis Patients
title Comparison of Early Clinical Results of Transcatheter versus Surgical Aortic Valve Replacement in Symptomatic High Risk Severe Aortic Stenosis Patients
title_full Comparison of Early Clinical Results of Transcatheter versus Surgical Aortic Valve Replacement in Symptomatic High Risk Severe Aortic Stenosis Patients
title_fullStr Comparison of Early Clinical Results of Transcatheter versus Surgical Aortic Valve Replacement in Symptomatic High Risk Severe Aortic Stenosis Patients
title_full_unstemmed Comparison of Early Clinical Results of Transcatheter versus Surgical Aortic Valve Replacement in Symptomatic High Risk Severe Aortic Stenosis Patients
title_short Comparison of Early Clinical Results of Transcatheter versus Surgical Aortic Valve Replacement in Symptomatic High Risk Severe Aortic Stenosis Patients
title_sort comparison of early clinical results of transcatheter versus surgical aortic valve replacement in symptomatic high risk severe aortic stenosis patients
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810556/
https://www.ncbi.nlm.nih.gov/pubmed/24175269
http://dx.doi.org/10.5090/kjtcs.2013.46.5.346
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