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Early and late outcomes after transcatheter versus surgical aortic valve replacement in obese patients
INTRODUCTION: Data on the early and late outcome following transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in obese patients are limited. We investigated whether TAVI may be superior to SAVR in obese patients. MATERIAL AND METHODS: Obese patients (body mas...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Termedia Publishing House
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286321/ https://www.ncbi.nlm.nih.gov/pubmed/32542080 http://dx.doi.org/10.5114/aoms.2019.85253 |
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author | Mariscalco, Giovanni D’Errigo, Paola Biancari, Fausto Rosato, Stefano Musumeci, Francesco Barbanti, Marco Ranucci, Marco Santoro, Gennaro Badoni, Gabriella Fusco, Danilo Ventura, Martina Tamburino, Corrado Seccareccia, Fulvia |
author_facet | Mariscalco, Giovanni D’Errigo, Paola Biancari, Fausto Rosato, Stefano Musumeci, Francesco Barbanti, Marco Ranucci, Marco Santoro, Gennaro Badoni, Gabriella Fusco, Danilo Ventura, Martina Tamburino, Corrado Seccareccia, Fulvia |
author_sort | Mariscalco, Giovanni |
collection | PubMed |
description | INTRODUCTION: Data on the early and late outcome following transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in obese patients are limited. We investigated whether TAVI may be superior to SAVR in obese patients. MATERIAL AND METHODS: Obese patients (body mass index ≥ 30 kg/m(2)) who underwent either SAVR or TAVI were identified from the nationwide OBSERVANT registry, and their in-hospital and long-term outcomes were analysed. Propensity score matching was employed to identify two cohorts with similar baseline characteristics. RESULTS: The propensity score matching provided 142 pairs balanced in terms of baseline risk factors. In-hospital and 30-day mortality did not differ between SAVR and TAVI obese patients (4.6% vs. 3.3%, p = 0.56, and 5.2% vs. 3.2%, p = 0.41, respectively). Obese SAVR patients experienced a higher rate of renal failure (12.4% vs. 3.6%, p = 0.0105) and blood transfusion requirement (60.3% vs. 25.7%, p < 0.0001) in comparison with TAVI patients. A higher rate of permanent pacemaker implantation (14.4% vs. 3.6%, p = 0.0018), and major vascular injuries (7.4% vs. 0%, p = 0.0044) occurred in the TAVI group. Five-year survival was higher in the SAVR group compared to the TAVI patient cohort (p = 0.0046), with survival estimates at 1, 3 and 5 years of 88.0%, 80.3%, 71.8% for patients undergoing SAVR, and 85.2%, 69.0%, 52.8% for those subjected to TAVI procedures. CONCLUSIONS: In obese patients, both SAVR and TAVI are valid treatment options, although in the long term SAVR exhibited higher survival rates. |
format | Online Article Text |
id | pubmed-7286321 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
spelling | pubmed-72863212020-06-14 Early and late outcomes after transcatheter versus surgical aortic valve replacement in obese patients Mariscalco, Giovanni D’Errigo, Paola Biancari, Fausto Rosato, Stefano Musumeci, Francesco Barbanti, Marco Ranucci, Marco Santoro, Gennaro Badoni, Gabriella Fusco, Danilo Ventura, Martina Tamburino, Corrado Seccareccia, Fulvia Arch Med Sci Clinical Research INTRODUCTION: Data on the early and late outcome following transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in obese patients are limited. We investigated whether TAVI may be superior to SAVR in obese patients. MATERIAL AND METHODS: Obese patients (body mass index ≥ 30 kg/m(2)) who underwent either SAVR or TAVI were identified from the nationwide OBSERVANT registry, and their in-hospital and long-term outcomes were analysed. Propensity score matching was employed to identify two cohorts with similar baseline characteristics. RESULTS: The propensity score matching provided 142 pairs balanced in terms of baseline risk factors. In-hospital and 30-day mortality did not differ between SAVR and TAVI obese patients (4.6% vs. 3.3%, p = 0.56, and 5.2% vs. 3.2%, p = 0.41, respectively). Obese SAVR patients experienced a higher rate of renal failure (12.4% vs. 3.6%, p = 0.0105) and blood transfusion requirement (60.3% vs. 25.7%, p < 0.0001) in comparison with TAVI patients. A higher rate of permanent pacemaker implantation (14.4% vs. 3.6%, p = 0.0018), and major vascular injuries (7.4% vs. 0%, p = 0.0044) occurred in the TAVI group. Five-year survival was higher in the SAVR group compared to the TAVI patient cohort (p = 0.0046), with survival estimates at 1, 3 and 5 years of 88.0%, 80.3%, 71.8% for patients undergoing SAVR, and 85.2%, 69.0%, 52.8% for those subjected to TAVI procedures. CONCLUSIONS: In obese patients, both SAVR and TAVI are valid treatment options, although in the long term SAVR exhibited higher survival rates. Termedia Publishing House 2019-05-21 /pmc/articles/PMC7286321/ /pubmed/32542080 http://dx.doi.org/10.5114/aoms.2019.85253 Text en Copyright © 2019 Termedia & Banach http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). License (http://creativecommons.org/licenses/by-nc-sa/4.0/) |
spellingShingle | Clinical Research Mariscalco, Giovanni D’Errigo, Paola Biancari, Fausto Rosato, Stefano Musumeci, Francesco Barbanti, Marco Ranucci, Marco Santoro, Gennaro Badoni, Gabriella Fusco, Danilo Ventura, Martina Tamburino, Corrado Seccareccia, Fulvia Early and late outcomes after transcatheter versus surgical aortic valve replacement in obese patients |
title | Early and late outcomes after transcatheter versus surgical aortic valve replacement in obese patients |
title_full | Early and late outcomes after transcatheter versus surgical aortic valve replacement in obese patients |
title_fullStr | Early and late outcomes after transcatheter versus surgical aortic valve replacement in obese patients |
title_full_unstemmed | Early and late outcomes after transcatheter versus surgical aortic valve replacement in obese patients |
title_short | Early and late outcomes after transcatheter versus surgical aortic valve replacement in obese patients |
title_sort | early and late outcomes after transcatheter versus surgical aortic valve replacement in obese patients |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286321/ https://www.ncbi.nlm.nih.gov/pubmed/32542080 http://dx.doi.org/10.5114/aoms.2019.85253 |
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