Beyersdorf, Friedhelm ORCID: 0000-0003-2975-2751, Bauer, Timm, Freemantle, Nick, Walther, Thomas, Frerker, Christian, Herrmann, Eva, Bleiziffer, Sabine, Moellmann, Helge, Landwehr, Sandra, Ensminger, Stephan, Bekeredjian, Raffi, Cremer, Jochen, Kuck, Karl Heinz, Fujita, Buntaro ORCID: 0000-0002-3262-7727, Gummert, Jan, Mueller, Lisa, Beckmann, Andreas and Hamm, Christian W. (2021). Five-year outcome in 18 010 patients from the German Aortic Valve Registry. Eur. J. Cardio-Thorac. Surg., 60 (5). S. 1139 - 1147. CARY: OXFORD UNIV PRESS INC. ISSN 1873-734X

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Abstract

OBJECTIVES: To determine the 5-year outcome in patients treated by isolated transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (sAVR)-a prospective observational cohort study. METHODS: A total of 18 010 patients were included (n = 8942 TAVI and n = 9068 sAVR) in the German Aortic Valve Registry (GARY) who were treated in 2011 and 2012 at 92 sites in central Germany. Eligible patients with TAVI and sAVR were matched using propensity scores in a nearest-neighbour approach. Patients with repeat procedures or unequivocal indication for one treatment option (e.g. frailty) were excluded (n = 4785 for TAVI and n = 2 for sAVR). This led to 13 223 patients (4157 TAVI and 9066 sAVR) as an unmatched subcohort. The main outcome measure was the 5-year all-cause mortality. RESULTS: TAVI patients were significantly older (80.9 +/- 6.1 vs 68.5 +/- 11.1 years, P < 0.001), had a higher Society of Thoracic Surgeons (STS) score (6.3 +/- 4.9 vs 2.6 +/- 3.0, P < 0.001) and a higher 5-year all-cause mortality (49.8% vs 16.5%, P < 0.0001). There was no major difference in in-hospital stroke, in-hospital myocardial infarction, or temporary and chronic dialysis. In the propensity score-matched group (n = 3640), there were 763 deaths (41.9%) among 1820 TAVI patients compared with 552 (30.3%) among 1820 treated with sAVR during the 5-year follow-up (hazard ratio 1.51, 95% confidence interval 1.35-1.68; P < 0.0001). New pacemaker implantation was performed in 448 patients (24.6%) after TAVI and in 201 (11.0%) after sAVR (P < 0.0001). CONCLUSIONS: The 5-year follow-up data show that TAVI patients were significantly older and had a higher STS score than sAVR patients. After propensity score matching, TAVI with early-generation prosthesis was associated with significantly higher 5-year all-cause mortality than sAVR. [GRAPHICS] .

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Beyersdorf, FriedhelmUNSPECIFIEDorcid.org/0000-0003-2975-2751UNSPECIFIED
Bauer, TimmUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Freemantle, NickUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Walther, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Frerker, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herrmann, EvaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bleiziffer, SabineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moellmann, HelgeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Landwehr, SandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ensminger, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bekeredjian, RaffiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cremer, JochenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuck, Karl HeinzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fujita, BuntaroUNSPECIFIEDorcid.org/0000-0002-3262-7727UNSPECIFIED
Gummert, JanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mueller, LisaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Beckmann, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hamm, Christian W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-602672
DOI: 10.1093/ejcts/ezab216
Journal or Publication Title: Eur. J. Cardio-Thorac. Surg.
Volume: 60
Number: 5
Page Range: S. 1139 - 1147
Date: 2021
Publisher: OXFORD UNIV PRESS INC
Place of Publication: CARY
ISSN: 1873-734X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
TRANSCATHETER; REPLACEMENTMultiple languages
Cardiac & Cardiovascular Systems; Respiratory System; SurgeryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60267

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