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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2019
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.
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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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