Universität zu Köln

Zubarevich, Alina, Szczechowicz, Marcin, Amanov, Lukman, Arjomandi Rad, Arian ORCID: 0000-0002-4931-4049, Osswald, Anja, Torabi, Saeed, Ruhparwar, Arjang and Weymann, Alexander (2022). Non-Inferiority of Sutureless Aortic Valve Replacement in the TAVR Era: David versus Goliath. Life-Basel, 12 (7). BASEL: MDPI. ISSN 2075-1729

Full text not available from this repository.

Abstract

Background: The rapid development of transcatheter treatment methods has made transcatheter aortic valve replacement (TAVR) a feasible alternative to conventional surgical aortic valve replacement (SAVR). Recently, indications for TAVR have been expanded to intermediate- and low-risk patients, although there still remains a portion of ineligible patients. We sought to evaluate and compare our experience with sutureless SAVR and transapical TAVR in the grey-area of patients unsuitable for transfemoral access. Methods: Between April 2018 and June 2021, 248 consecutive patients underwent a sutureless SAVR (SU-SAVR) or TA-TAVR at our institution. We performed a pair-matched analysis and identified 56 patient pairs based on the EuroSCORE II. All transcatheter procedures were performed using SAPIEN XT/3 (TM) prostheses, while all surgical procedures deployed the Perceval (LivaNova) aortic valve. Results: All patients presented with multiple comorbidities as reflected by the median EuroSCORE-II of 3.1% (IQR 1.9-5.3). Thirty-four patients from the surgical group (60.7%) underwent a concomitant myocardial revascularization. There was no significant difference in major adverse events, pacemaker implantation or postoperative mortality during follow-up. Both interventions demonstrated technical success with similar mean postoperative pressure gradients at follow-up and no cases of paravalvular leakage. Conclusions: Sutureless aortic valve replacement constitutes a feasible treatment alternative for patients with aortic valve disease who are ineligible for transfemoral access route and/or require concomitant coronary revascularization. With its excellent hemodynamic performance, similar survival compared to TA-TAVR, and high cost-efficiency without compromising the postoperative outcomes and in-hospital length of stay SU-AVR might be considered for patients in the grey-area between TAVR and SAVR.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Zubarevich, Alina UNSPECIFIED UNSPECIFIED UNSPECIFIED Szczechowicz, Marcin UNSPECIFIED UNSPECIFIED UNSPECIFIED Amanov, Lukman UNSPECIFIED UNSPECIFIED UNSPECIFIED Arjomandi Rad, Arian UNSPECIFIED orcid.org/0000-0002-4931-4049 UNSPECIFIED Osswald, Anja UNSPECIFIED UNSPECIFIED UNSPECIFIED Torabi, Saeed UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruhparwar, Arjang UNSPECIFIED UNSPECIFIED UNSPECIFIED Weymann, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-674152
DOI:	10.3390/life12070979
Journal or Publication Title:	Life-Basel
Volume:	12
Number:	7
Date:	2022
Publisher:	MDPI
Place of Publication:	BASEL
ISSN:	2075-1729
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CONVENTIONAL SURGERY; TRANSCATHETER; IMPLANTATION; METAANALYSIS; ZONE Multiple languages Biology; Microbiology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67415