Universität zu Köln

Faerber, Gloria, Bleiziffer, Sabine, Doenst, Torsten, Bon, Dimitra, Boening, Andreas, Weiler, Helge, Herrmann, Eva, Frerker, Christian, Beckmann, Andreas, Moellmann, Helge, Ensminger, Stephan, Bekeredjian, Raffi, Walther, Thomas, Harringer, Wolfgang, Katus, Hugo A., Hamm, Christian W., Beyersdorf, Friedhelm, Bauer, Timm and Fichtlscherer, Stephan . Transcatheter or surgical aortic valve implantation in chronic dialysis patients: a German Aortic Valve Registry analysis. Clin. Res. Cardiol.. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1861-0692

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Abstract

Objectives The aim of this study was to compare outcomes of transcatheter and surgical aortic valve implantation in chronic dialysis patients with aortic valve stenosis (AS). Background Chronic dialysis patients undergoing heart valve surgery are at higher risk for morbidity and mortality. Whether interventional techniques can reduce this risk is unclear because dialysis patients have thus far been excluded from randomized trials. Methods Chronic dialysis patients with AS enrolled in the German Aortic Valve Registry (GARY) between 2012 and 2015 were analyzed to compare transcatheter aortic valve implantation (TAVIn = 661) with surgical aortic valve replacement (SAVRn = 457). Propensity scores for inverse probability of treatment weighting (IPTW) were used to adjust the comparison of the two treatment groups for potential confounders. Results TAVI patients were older (78 +/- 7.3 vs. 69 +/- 10.2 years,p < 0.01, unadjusted) and had more comorbidities. Mortality at 1 year was the same (TAVI: 33.4% vs. SAVR 35.0%,p = 0.72, IPTW-adjusted) while it was lower with TAVI at 30 days (8.6% vs. 15.0%,p = 0.02, IPTW-adjusted). TAVI patients required more pacemaker implantation and showed more aortic regurgitation. SAVR patients required more blood transfusions and had longer hospital stay. Diabetes mellitus, atrial fibrillation, previous PCI, urgent procedure and EuroSCORE were associated with elevated 30-day mortality. Atrial fibrillation and older age were independent risk factor of 1-year mortality in both groups. Conclusions Chronic dialysis patients with AS undergoing TAVI or SAVR had the same 1-year mortality, although survival at 30 days was better with TAVI. These results suggest that TAVI may improve peri-procedural outcomes.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Faerber, Gloria UNSPECIFIED UNSPECIFIED UNSPECIFIED Bleiziffer, Sabine UNSPECIFIED UNSPECIFIED UNSPECIFIED Doenst, Torsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Bon, Dimitra UNSPECIFIED UNSPECIFIED UNSPECIFIED Boening, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Weiler, Helge UNSPECIFIED UNSPECIFIED UNSPECIFIED Herrmann, Eva UNSPECIFIED UNSPECIFIED UNSPECIFIED Frerker, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Beckmann, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Moellmann, Helge UNSPECIFIED UNSPECIFIED UNSPECIFIED Ensminger, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Bekeredjian, Raffi UNSPECIFIED UNSPECIFIED UNSPECIFIED Walther, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Harringer, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Katus, Hugo A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamm, Christian W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Beyersdorf, Friedhelm UNSPECIFIED UNSPECIFIED UNSPECIFIED Bauer, Timm UNSPECIFIED UNSPECIFIED UNSPECIFIED Fichtlscherer, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-318488
DOI:	10.1007/s00392-020-01717-7
Journal or Publication Title:	Clin. Res. Cardiol.
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1861-0692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CHRONIC KIDNEY-DISEASE; STAGE RENAL-DISEASE; REPLACEMENT; STENOSIS; OUTCOMES; THERAPY; SCORE; GARY Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31848