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Acute and late outcomes of transcatheter aortic valve implantation (TAVI) for the treatment of severe symptomatic aortic stenosis in patients at high- and low-surgical risk

Background: This prospective study examines the impact of EuroSCORE and transfemoral (TF) or transapical (TA) delivery approach on mortality at 30 days and 1 year in patients with severe aortic stenosis implanted with either the Edwards SAPIEN Transcatheter Heart Valve (THV) or Medtronic CoreValve....

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Bibliographic Details
Main Authors: Schymik, Gerhard (Author) , Süselbeck, Tim (Author)
Format: Article (Journal)
Language:English
Published: 2012
In: Journal of interventional cardiology
Year: 2012, Volume: 25, Issue: 4, Pages: 364-374
ISSN:1540-8183
DOI:10.1111/j.1540-8183.2012.00729.x
Online Access:Verlag, Volltext: http://dx.doi.org/10.1111/j.1540-8183.2012.00729.x
Verlag, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1540-8183.2012.00729.x
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Author Notes:Gerhard Schymik, M.D., Holger Schröfel, M.D., Jan S. Schymik, Rainer Wondraschek, Tim Süselbeck, M.D., Rüdiger Kiefer, Veronika Balthasar, M.D., Armin Luik, M.D., Herbert Posival, M.D., Claus Schmitt, M.D.
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Summary:Background: This prospective study examines the impact of EuroSCORE and transfemoral (TF) or transapical (TA) delivery approach on mortality at 30 days and 1 year in patients with severe aortic stenosis implanted with either the Edwards SAPIEN Transcatheter Heart Valve (THV) or Medtronic CoreValve. Methods and Results: TAVI was successfully performed in 293 (97.7%) of 300 patients (TF: 174, TA: 126, mean EuroSCORE 24.0). The mortality at 30 days and after 1 year was 6.0% and 17.3%. Mortality depends significantly on the logistic EuroSCORE with a 30-day odds ratio (OR) of 1.92 (95% CI 1.41 to 2.62, P < 0.001) and after 1 year of 1.67 (95% CI 1.34 to 2.08, P < 0.001). Mortality in patients with a logistic EuroSCORE <15 (n = 113) or ≥15 (n = 187) at 30 days was 0.9% versus 9.1% and after 1 year 7.1% versus 23.5% demonstrating significantly less mortality (P < 0.001) in patients with lower logistic EuroSCOREs. In this specific setup of our center there was no significant difference (P = 0.553) in mortality regarding the technical approach for TA (4.0% and 15.9%) and for TF (7.5% and 18.4%). Severe cardiac complications occurred in 20 patients (6.7%) with a 30-day mortality of 45.0%. Conclusion: The mortality in patients undergoing TAVI correlates significantly with the logistic EuroSCORE. Patients with a logistic EuroSCORE <15 can be implanted, with a low 30-day mortality and good long-term outcome over 1 year. (J Interven Cardiol 2012;25:364-374)
Item Description:First published: 25 May 2012
Gesehen am 20.06.2018
Physical Description:Online Resource
ISSN:1540-8183
DOI:10.1111/j.1540-8183.2012.00729.x

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