Universität zu Köln

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:	Creators Email ORCID ORCID Put Code Scherner, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Madershahian, Navid UNSPECIFIED UNSPECIFIED UNSPECIFIED Rosenkranz, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Slottosch, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Elmar UNSPECIFIED UNSPECIFIED UNSPECIFIED Langebartels, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Deppe, Antje UNSPECIFIED UNSPECIFIED UNSPECIFIED Wippermann, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Choi, Yeong-Hoon UNSPECIFIED UNSPECIFIED UNSPECIFIED Strauch, Justus T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
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:	Keywords Language HIGH-RISK PATIENTS; END-POINT DEFINITIONS; ELDERLY-PATIENTS; STENOSIS; REPLACEMENT; RETROGRADE; DECISION; OUTCOMES Multiple languages Cardiac & Cardiovascular Systems; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47961