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Comparison of Sutureless Bioprosthetic Valve With Surgical or TAVR for Severe Aortic Stenosis
BACKGROUND: Clinical advantages of sutureless rapid-deployment (RD) aortic valve replacement (AVR) for severe aortic valve stenosis (AS) have not been elucidated compared with surgical (SAVR) or transcatheter (TAVR) aortic valve replacement. OBJECTIVES: This study sought to investigate comparative e...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9627931/ https://www.ncbi.nlm.nih.gov/pubmed/36341221 http://dx.doi.org/10.1016/j.jacasi.2021.08.007 |
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author | Kim, Ho Jin Kang, Do-Yoon Park, Hanbit Ahn, Jung-Min Kim, Joon Bum Kim, Seon-Ok Ok, You Jung Lee, Seung Hun Pyo, Won Kyung Ko, Euihong Lee, Seung-Ah Kim, Dae-Hee Park, Seung-Jung Park, Duk-Woo Choo, Suk Jung |
author_facet | Kim, Ho Jin Kang, Do-Yoon Park, Hanbit Ahn, Jung-Min Kim, Joon Bum Kim, Seon-Ok Ok, You Jung Lee, Seung Hun Pyo, Won Kyung Ko, Euihong Lee, Seung-Ah Kim, Dae-Hee Park, Seung-Jung Park, Duk-Woo Choo, Suk Jung |
author_sort | Kim, Ho Jin |
collection | PubMed |
description | BACKGROUND: Clinical advantages of sutureless rapid-deployment (RD) aortic valve replacement (AVR) for severe aortic valve stenosis (AS) have not been elucidated compared with surgical (SAVR) or transcatheter (TAVR) aortic valve replacement. OBJECTIVES: This study sought to investigate comparative effectiveness and safety of RD-AVR compared with SAVR and TAVR in a prospective cohort of patients with severe AS. METHODS: The primary outcome was a composite of death, stroke, or rehospitalization at 12 months. Propensity score matching was used to assemble a cohort of patients with similar baseline characteristics. RESULTS: Among 1,020 eligible patients, 107 (10.5%) underwent RD-AVR, 437 (42.8%) underwent SAVR, and 476 (46.7%) underwent TAVR. In the matched cohorts of RD-AVR and SAVR (n = 107), the incidence of primary composite outcome at 12 months was similar between the 2 groups (8.0% vs 10.8%, respectively; hazard ratio [HR]: 0.74; 95% confidence interval [CI]: 0.30-1.84; P = 0.52). In the matched cohorts of RD and TAVR (n = 58), the incidence of primary composite outcome at 12 months did not statistically differ between the 2 groups (9.4% vs 16.2%, respectively; HR: 0.53; 95% CI: 0.18-1.57; P = 0.25). CONCLUSIONS: In this propensity-matched cohort of patients who underwent AVR for severe AS, we did not detect significant differences in the rates of the primary composite of death, stroke, or rehospitalization at 12 months when comparing RD-AVR with SAVR and TAVR. Because the study was underpowered, the results should be considered as hypothesis generating highlighting the need for further research. (ASAN Medical Center Aortic Valve Replacement Registry [ASAN-AVR]; NCT03298178) |
format | Online Article Text |
id | pubmed-9627931 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-96279312022-11-04 Comparison of Sutureless Bioprosthetic Valve With Surgical or TAVR for Severe Aortic Stenosis Kim, Ho Jin Kang, Do-Yoon Park, Hanbit Ahn, Jung-Min Kim, Joon Bum Kim, Seon-Ok Ok, You Jung Lee, Seung Hun Pyo, Won Kyung Ko, Euihong Lee, Seung-Ah Kim, Dae-Hee Park, Seung-Jung Park, Duk-Woo Choo, Suk Jung JACC Asia Original Research BACKGROUND: Clinical advantages of sutureless rapid-deployment (RD) aortic valve replacement (AVR) for severe aortic valve stenosis (AS) have not been elucidated compared with surgical (SAVR) or transcatheter (TAVR) aortic valve replacement. OBJECTIVES: This study sought to investigate comparative effectiveness and safety of RD-AVR compared with SAVR and TAVR in a prospective cohort of patients with severe AS. METHODS: The primary outcome was a composite of death, stroke, or rehospitalization at 12 months. Propensity score matching was used to assemble a cohort of patients with similar baseline characteristics. RESULTS: Among 1,020 eligible patients, 107 (10.5%) underwent RD-AVR, 437 (42.8%) underwent SAVR, and 476 (46.7%) underwent TAVR. In the matched cohorts of RD-AVR and SAVR (n = 107), the incidence of primary composite outcome at 12 months was similar between the 2 groups (8.0% vs 10.8%, respectively; hazard ratio [HR]: 0.74; 95% confidence interval [CI]: 0.30-1.84; P = 0.52). In the matched cohorts of RD and TAVR (n = 58), the incidence of primary composite outcome at 12 months did not statistically differ between the 2 groups (9.4% vs 16.2%, respectively; HR: 0.53; 95% CI: 0.18-1.57; P = 0.25). CONCLUSIONS: In this propensity-matched cohort of patients who underwent AVR for severe AS, we did not detect significant differences in the rates of the primary composite of death, stroke, or rehospitalization at 12 months when comparing RD-AVR with SAVR and TAVR. Because the study was underpowered, the results should be considered as hypothesis generating highlighting the need for further research. (ASAN Medical Center Aortic Valve Replacement Registry [ASAN-AVR]; NCT03298178) Elsevier 2021-10-26 /pmc/articles/PMC9627931/ /pubmed/36341221 http://dx.doi.org/10.1016/j.jacasi.2021.08.007 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Research Kim, Ho Jin Kang, Do-Yoon Park, Hanbit Ahn, Jung-Min Kim, Joon Bum Kim, Seon-Ok Ok, You Jung Lee, Seung Hun Pyo, Won Kyung Ko, Euihong Lee, Seung-Ah Kim, Dae-Hee Park, Seung-Jung Park, Duk-Woo Choo, Suk Jung Comparison of Sutureless Bioprosthetic Valve With Surgical or TAVR for Severe Aortic Stenosis |
title | Comparison of Sutureless Bioprosthetic Valve With Surgical or TAVR for Severe Aortic Stenosis |
title_full | Comparison of Sutureless Bioprosthetic Valve With Surgical or TAVR for Severe Aortic Stenosis |
title_fullStr | Comparison of Sutureless Bioprosthetic Valve With Surgical or TAVR for Severe Aortic Stenosis |
title_full_unstemmed | Comparison of Sutureless Bioprosthetic Valve With Surgical or TAVR for Severe Aortic Stenosis |
title_short | Comparison of Sutureless Bioprosthetic Valve With Surgical or TAVR for Severe Aortic Stenosis |
title_sort | comparison of sutureless bioprosthetic valve with surgical or tavr for severe aortic stenosis |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9627931/ https://www.ncbi.nlm.nih.gov/pubmed/36341221 http://dx.doi.org/10.1016/j.jacasi.2021.08.007 |
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