Scherner, Maximilian, Madershahian, Navid, Rosenkranz, Stephan, Slottosch, Ingo, Kuhn, Elmar, Langebartels, Georg, Deppe, Antje, Wippermann, Jens, Choi, Yeong-Hoon, Strauch, Justus T. and Wahlers, Thorsten (2012). Transapical Aortic Valve Implantation: Experiences and Survival Analysis up to Three Years. J. Card. Surg., 27 (6). S. 653 - 662. HOBOKEN: WILEY. ISSN 1540-8191

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Abstract

Background: We determined our 30-day results after transapical aortic valve implantation (TA-AVI) according to Valve Academic Research Consortium criteria, analyzed midterm outcome, and summarize our institutional learning experience. Methods: From February 2008 to July 2011, 150 high-risk patients underwent TA-AVI. Endpoints of this retrospective analysis were safety as indicated by morbidity and 30-day mortality and midterm survival with a follow-up period up to 3.4 years (mean follow-up 14.1 months). In addition we analyzed our institutional learning curve by comparing the outcome of our first 50 patients (group 1) to the following 100 patients (group 2). Results: Procedural success was 98% (147 patients). All-cause and cardiovascular cause 30-day mortality was 11.3% (n = 17) and 7.3% (n = 11), respectively. The cumulative survival rates were 78.7% at one year, 62.8% at two years, and 50.8% at three years. As compared to group 1, there was a significantly reduced incidence of relevant bleeding complications (0% vs. 14%[n = 7]; p < 0.001) and a reduced incidence of acute kidney injury (35%[n = 35] versus 56% (n = 28); p < 0.05) in group 2, resulting in a combined safety endpoint at 30 days of 22% in group 2 versus 40% in group 1 (p < 0.05). One-year mortality (group 2, n = 20 [20%] versus group 1, n = 10 [20%]; p = 1) and midterm survival (p = 0.998; Hazard ratio 1.001; 95% CI 0.5141 to 1.949) did not differ significantly. Conclusions: Although the incidence of technical complications decreased significantly over time, 30-day and midterm mortality were unaltered, most likely due to patients' comorbidities. The development of more accurate risk scores may improve future outcome. (J Card Surg 2012;27:653-661)

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Scherner, MaximilianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Madershahian, NavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rosenkranz, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Slottosch, IngoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuhn, ElmarUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Langebartels, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Deppe, AntjeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wippermann, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Choi, Yeong-HoonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Strauch, Justus T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wahlers, ThorstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-479615
DOI: 10.1111/jocs.12001
Journal or Publication Title: J. Card. Surg.
Volume: 27
Number: 6
Page Range: S. 653 - 662
Date: 2012
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1540-8191
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
HIGH-RISK PATIENTS; END-POINT DEFINITIONS; ELDERLY-PATIENTS; STENOSIS; REPLACEMENT; RETROGRADE; DECISION; OUTCOMESMultiple languages
Cardiac & Cardiovascular Systems; SurgeryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/47961

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