Universität zu Köln

Mas-Peiro, Silvia ORCID: 0000-0002-3828-8180, Faerber, Gloria, Bon, Dimitra, Herrmann, Eva, Bauer, Timm, Bleiziffer, Sabine, Bekeredjian, Raffi, Boening, Andreas, Frerker, Christian, Beckmann, Andreas, Moellmann, Helge, Ensminger, Stephan, Hamm, Christian W., Beyersdorf, Friedhelm, Fichtlscherer, Stephan and Walther, Thomas (2022). Propensity matched comparison of TAVI and SAVR in intermediate-risk patients with severe aortic stenosis and moderate-to-severe chronic kidney disease: a subgroup analysis from the German Aortic Valve Registry. Clin. Res. Cardiol., 111 (12). S. 1387 - 1396. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1861-0692

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Abstract

Objective We compared TAVI vs. SAVR in patients with moderate-to-severe chronic kidney disease (eGFR 15-60 ml/min/1.73 m(2)) for whom both procedures could possibly be considered (age <= 80 years, STS-score 4-8). Background According to both ACC/AHA and ESC/EACTS recent guidelines, aortic stenosis may be treated with either transcatheter (TAVI) or surgical (SAVR) aortic valve replacement in a subgroup of patients. A shared therapeutic decision is made by a heart team based on individual factors, including chronic kidney disease (CKD). Methods Data from the large nationwide German Aortic Valve Registry were used. A propensity score method was used to select 704 TAVI and 374 SAVR matched patients. Primary endpoint was 1-year survival. Secondary endpoints were clinical complications, including pacemaker implantation, vascular complications, myocardial infarction, bleeding, and the need for new-onset dialysis. Results One-year survival was similar (HR [95% CI] for TAVI 1.271 [0.795, 2.031], p = 0.316), with no divergence in Kaplan-Meier curves. In spite of post-procedural short-term survival being numerically higher for TAVI patients and 1-year survival being numerically higher for SAVR patients, such differences did not reach statistical significance (96.4% vs. 94.2%, p = 0.199, and 86.2% vs. 81.2%, p = 0.316, respectively). In weighted analyses, pacemaker implantation, vascular complications, and were significantly more common with TAVI; whereas myocardial infarction, bleeding requiring transfusion, and longer ICU-stay and overall hospitalization were higher with SAVR. Temporary dialysis was more common with SAVR (p < 0.0001); however, a probable need for chronic dialysis was rare and similar in both groups. Conclusion Both TAVI and SAVR led to comparable and excellent results in patients with moderate-to-severe CKD in an intermediate-risk population of patients with symptomatic severe aortic stenosis for whom both therapies could possibly be considered.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mas-Peiro, Silvia UNSPECIFIED orcid.org/0000-0002-3828-8180 UNSPECIFIED Faerber, Gloria UNSPECIFIED UNSPECIFIED UNSPECIFIED Bon, Dimitra UNSPECIFIED UNSPECIFIED UNSPECIFIED Herrmann, Eva UNSPECIFIED UNSPECIFIED UNSPECIFIED Bauer, Timm UNSPECIFIED UNSPECIFIED UNSPECIFIED Bleiziffer, Sabine UNSPECIFIED UNSPECIFIED UNSPECIFIED Bekeredjian, Raffi UNSPECIFIED UNSPECIFIED UNSPECIFIED Boening, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Frerker, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Beckmann, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Moellmann, Helge UNSPECIFIED UNSPECIFIED UNSPECIFIED Ensminger, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamm, Christian W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Beyersdorf, Friedhelm UNSPECIFIED UNSPECIFIED UNSPECIFIED Fichtlscherer, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Walther, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-693866
DOI:	10.1007/s00392-022-02083-2
Journal or Publication Title:	Clin. Res. Cardiol.
Volume:	111
Number:	12
Page Range:	S. 1387 - 1396
Date:	2022
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1861-0692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language VALVULAR HEART-DISEASE; PROGNOSTIC VALUE; TRANSCATHETER; REPLACEMENT; IMPLANTATION; ASSOCIATION; MANAGEMENT Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69386