Patients at intermediate surgical risk undergoing isolated interventional or surgical aortic valve implantation for severe symptomatic aortic valve stenosis: One-year results from the German Aortic Valve Registry

Background: Transcatheter aortic valve replacement (TAVR) is increasingly being used for treatment of severe aortic valve stenosis in patients at intermediate risk for surgical aortic valve replacement (SAVR). Currently, real-world data comparing indications and clinical outcomes of patients at inte...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Hauptverfasser: Werner, Nicolas (VerfasserIn) , Katus, Hugo (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: December 4, 2018
In: Circulation
Year: 2018, Jahrgang: 138, Heft: 23, Pages: 2611-2623
ISSN:1524-4539
DOI:10.1161/CIRCULATIONAHA.117.033048
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1161/CIRCULATIONAHA.117.033048
Verlag, lizenzpflichtig, Volltext: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.117.033048
Volltext
Verfasserangaben:Nicolas Werner, Ralf Zahn, Andreas Beckmann, Timm Bauer, Sabine Bleiziffer, Christian W. Hamm, Raffi Berkeredjian, Alexander Berkowitsch, Friedrich W. Mohr, Sandra Landwehr, Hugo A. Katus, Wolfgang Harringer, Stephan Ensminger, Christian Frerker, Helge Möllmann, Thomas Walther, Steffen Schneider, Rüdiger Lange

MARC

LEADER 00000caa a2200000 c 4500
001 1692369245
003 DE-627
005 20220818012647.0
007 cr uuu---uuuuu
008 200312s2018 xx |||||o 00| ||eng c
024 7 |a 10.1161/CIRCULATIONAHA.117.033048  |2 doi 
035 |a (DE-627)1692369245 
035 |a (DE-599)KXP1692369245 
035 |a (OCoLC)1341310103 
040 |a DE-627  |b ger  |c DE-627  |e rda 
041 |a eng 
084 |a 33  |2 sdnb 
100 1 |a Werner, Nicolas  |d 1981-  |e VerfasserIn  |0 (DE-588)141445475  |0 (DE-627)627791387  |0 (DE-576)323915809  |4 aut 
245 1 0 |a Patients at intermediate surgical risk undergoing isolated interventional or surgical aortic valve implantation for severe symptomatic aortic valve stenosis  |b One-year results from the German Aortic Valve Registry  |c Nicolas Werner, Ralf Zahn, Andreas Beckmann, Timm Bauer, Sabine Bleiziffer, Christian W. Hamm, Raffi Berkeredjian, Alexander Berkowitsch, Friedrich W. Mohr, Sandra Landwehr, Hugo A. Katus, Wolfgang Harringer, Stephan Ensminger, Christian Frerker, Helge Möllmann, Thomas Walther, Steffen Schneider, Rüdiger Lange 
264 1 |c December 4, 2018 
300 |a 13 
336 |a Text  |b txt  |2 rdacontent 
337 |a Computermedien  |b c  |2 rdamedia 
338 |a Online-Ressource  |b cr  |2 rdacarrier 
500 |a Gesehen am 12.03.2020 
520 |a Background: Transcatheter aortic valve replacement (TAVR) is increasingly being used for treatment of severe aortic valve stenosis in patients at intermediate risk for surgical aortic valve replacement (SAVR). Currently, real-world data comparing indications and clinical outcomes of patients at intermediate surgical risk undergoing isolated TAVR with those undergoing SAVR are scarce. Methods: We compared clinical characteristics and outcomes of patients with intermediate surgical risk (Society of Thoracic Surgeons score 4%-8%) who underwent isolated TAVR or conventional SAVR within the prospective, all-comers German Aortic Valve Registry. Results: A total of 7613 patients at intermediate surgical risk underwent isolated TAVR (n=6469) or SAVR (n=1144) at 92 sites in Germany between 2012 and 2014. Patients treated by TAVR were significantly older (82.5±5.0 versus 76.6±6.7 years, P<0.001) and had higher risk scores (logistic EuroSCORE [European System for Cardiac Operative Risk Evaluation]: 21.2±12.3% versus 14.2±9.5%, P<0.001; Society of Thoracic Surgeons score: 5.6±1.1 versus 5.2±1.0, P<0.001). Multivariable analyses revealed that advanced age, coronary artery disease, New York Heart Association class III/IV, pulmonary hypertension, prior cardiac decompensation, elective procedure, arterial occlusive disease, no diabetes mellitus, and a smaller aortic valve area were associated with performing TAVR instead of SAVR (all P<0.001). Unadjusted in-hospital mortality rates were equal for TAVR and SAVR (3.6% versus 3.6%, P=0.976), whereas unadjusted 1-year mortality was significantly higher in patients after TAVR (17.5% versus 10.8%, P<0.001). After propensity score matching, the difference in 1-year mortality between patients with TAVR and SAVR was no longer significant (17.1% versus 15.7%, P=0.59).Conclusions:Patients at intermediate risk undergoing TAVR differ significantly from those treated with SAVR with regard to age and baseline characteristics. Isolated TAVR and SAVR were associated with an in-hospital mortality rate of 3.6%. In the propensity score analysis, there was no significant difference in 1-year mortality between patients with TAVR and SAVR. 
700 1 |a Katus, Hugo  |d 1951-  |e VerfasserIn  |0 (DE-588)108916618  |0 (DE-627)577155040  |0 (DE-576)289625076  |4 aut 
773 0 8 |i Enthalten in  |t Circulation  |d Philadelphia, Pa. : Lippincott, Williams & Wilkins, 1950  |g 138(2018), 23, Seite 2611-2623  |h Online-Ressource  |w (DE-627)265784670  |w (DE-600)1466401-X  |w (DE-576)074891189  |x 1524-4539  |7 nnas  |a Patients at intermediate surgical risk undergoing isolated interventional or surgical aortic valve implantation for severe symptomatic aortic valve stenosis One-year results from the German Aortic Valve Registry 
773 1 8 |g volume:138  |g year:2018  |g number:23  |g pages:2611-2623  |g extent:13  |a Patients at intermediate surgical risk undergoing isolated interventional or surgical aortic valve implantation for severe symptomatic aortic valve stenosis One-year results from the German Aortic Valve Registry 
856 4 0 |u https://doi.org/10.1161/CIRCULATIONAHA.117.033048  |x Verlag  |x Resolving-System  |z lizenzpflichtig  |3 Volltext 
856 4 0 |u https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.117.033048  |x Verlag  |z lizenzpflichtig  |3 Volltext 
951 |a AR 
992 |a 20200312 
993 |a Article 
994 |a 2018 
998 |g 108916618  |a Katus, Hugo  |m 108916618:Katus, Hugo  |d 910000  |d 910100  |e 910000PK108916618  |e 910100PK108916618  |k 0/910000/  |k 1/910000/910100/  |p 11 
999 |a KXP-PPN1692369245  |e 3607093105 
BIB |a Y 
SER |a newspaper 
JSO |a {"title":[{"subtitle":"One-year results from the German Aortic Valve Registry","title":"Patients at intermediate surgical risk undergoing isolated interventional or surgical aortic valve implantation for severe symptomatic aortic valve stenosis","title_sort":"Patients at intermediate surgical risk undergoing isolated interventional or surgical aortic valve implantation for severe symptomatic aortic valve stenosis"}],"type":{"media":"Online-Ressource","bibl":"article-newspaper"},"id":{"doi":["10.1161/CIRCULATIONAHA.117.033048"],"eki":["1692369245"]},"physDesc":[{"extent":"13 S."}],"relHost":[{"part":{"volume":"138","year":"2018","text":"138(2018), 23, Seite 2611-2623","issue":"23","pages":"2611-2623","extent":"13"},"language":["eng"],"note":["Gesehen am 10.10.2025"],"pubHistory":["1.1950 -"],"corporate":[{"role":"isb","display":"American Heart Association"}],"disp":"Patients at intermediate surgical risk undergoing isolated interventional or surgical aortic valve implantation for severe symptomatic aortic valve stenosis One-year results from the German Aortic Valve RegistryCirculation","type":{"bibl":"newspaper","media":"Online-Ressource"},"recId":"265784670","id":{"zdb":["1466401-X"],"issn":["1524-4539"],"eki":["265784670"]},"physDesc":[{"extent":"Online-Ressource"}],"title":[{"title":"Circulation","subtitle":"an official journal of the American Heart Association","title_sort":"Circulation"}],"origin":[{"publisher":"Lippincott, Williams & Wilkins ; Ovid","dateIssuedDisp":"1950-","dateIssuedKey":"1950","publisherPlace":"Philadelphia, Pa. ; [Erscheinungsort nicht ermittelbar]"}]}],"origin":[{"dateIssuedKey":"2018","dateIssuedDisp":"December 4, 2018"}],"language":["eng"],"name":{"displayForm":["Nicolas Werner, Ralf Zahn, Andreas Beckmann, Timm Bauer, Sabine Bleiziffer, Christian W. Hamm, Raffi Berkeredjian, Alexander Berkowitsch, Friedrich W. Mohr, Sandra Landwehr, Hugo A. Katus, Wolfgang Harringer, Stephan Ensminger, Christian Frerker, Helge Möllmann, Thomas Walther, Steffen Schneider, Rüdiger Lange"]},"person":[{"given":"Nicolas","display":"Werner, Nicolas","role":"aut","family":"Werner"},{"role":"aut","family":"Katus","display":"Katus, Hugo","given":"Hugo"}],"recId":"1692369245","note":["Gesehen am 12.03.2020"]} 
SRT |a WERNERNICOPATIENTSAT4201