The aim of this study was to compare the immediate outcome of patients undergoing transcatheter (TAVI) versus surgical aortic valve replacement with the sutureless Perceval bioprosthesis (SU-AVR). This is a retrospective multicenter analysis of 773 patients who underwent either TAVI (394 patients, mean age, 80.8 ± 5.5 years, mean EuroSCORE II 5.6 ± 4.9 %) or SU-AVR (379 patients, 77.4 ± 5.4 years, mean EuroSCORE II 4.0 ± 3.9 %) with or without concomitant myocardial revascularization. Data on SU-AVRs were provided by six European institutions (Belgium, Finland, Germany, Italy and Sweden) and data on TAVIs were provided by a single institution (Catania, Italy). In-hospital mortality was 2.6 % after SU-AVR and 5.3 % after TAVI (p = 0.057). TAVI was associated with a significantly high rate of mild (44.0 vs. 2.1 %) and moderate-severe paravalvular regurgitation (14.1 vs. 0.3 %, p < 0.0001) as well as the need for permanent pacemaker implantation (17.3 vs. 9.8 %, p = 0.003) compared with SU-AVR. The analysis of patients within the 25th and 75th percentiles interval of EuroSCORE II, i.e., 2.1-5.8 %, confirmed the findings of the overall series. One-to-one propensity score-matched analysis resulted in 144 pairs with similar baseline characteristics and operative risk. Among these matched pairs, in-hospital mortality (6.9 vs. 1.4 %, p = 0.035) was significantly higher after TAVI. SU-AVR with the Perceval prosthesis in intermediate-risk patients is associated with excellent immediate survival and is a valid alternative to TAVI in these patients.

Immediate outcome after sutureless versus transcatheter aortic valve replacement / Biancari, Fausto; Barbanti, Marco; Santarpino, Giuseppe; Deste, Wanda; Tamburino, Corrado; Gulino, Simona; Immè, Sebastiano; Di Simone, Emanuela; Todaro, Denise; Pollari, Francesco; Fischlein, Theodor; Kasama, Keiichiro; Meuris, Bart; Dalén, Magnus; Sartipy, Ulrik; Svenarud, Peter; Lahtinen, Jarmo; Heikkinen, Jouni; Juvonen, Tatu; Gatti, Giuseppe; Pappalardo, Aniello; Mignosa, Carmelo; Rubino, Antonino S.. - In: HEART AND VESSELS. - ISSN 0910-8327. - STAMPA. - 31:3(2016), pp. 427-433. [10.1007/s00380-014-0623-3]

Immediate outcome after sutureless versus transcatheter aortic valve replacement

Pollari, Francesco;GATTI, GIUSEPPE;
2016

Abstract

The aim of this study was to compare the immediate outcome of patients undergoing transcatheter (TAVI) versus surgical aortic valve replacement with the sutureless Perceval bioprosthesis (SU-AVR). This is a retrospective multicenter analysis of 773 patients who underwent either TAVI (394 patients, mean age, 80.8 ± 5.5 years, mean EuroSCORE II 5.6 ± 4.9 %) or SU-AVR (379 patients, 77.4 ± 5.4 years, mean EuroSCORE II 4.0 ± 3.9 %) with or without concomitant myocardial revascularization. Data on SU-AVRs were provided by six European institutions (Belgium, Finland, Germany, Italy and Sweden) and data on TAVIs were provided by a single institution (Catania, Italy). In-hospital mortality was 2.6 % after SU-AVR and 5.3 % after TAVI (p = 0.057). TAVI was associated with a significantly high rate of mild (44.0 vs. 2.1 %) and moderate-severe paravalvular regurgitation (14.1 vs. 0.3 %, p < 0.0001) as well as the need for permanent pacemaker implantation (17.3 vs. 9.8 %, p = 0.003) compared with SU-AVR. The analysis of patients within the 25th and 75th percentiles interval of EuroSCORE II, i.e., 2.1-5.8 %, confirmed the findings of the overall series. One-to-one propensity score-matched analysis resulted in 144 pairs with similar baseline characteristics and operative risk. Among these matched pairs, in-hospital mortality (6.9 vs. 1.4 %, p = 0.035) was significantly higher after TAVI. SU-AVR with the Perceval prosthesis in intermediate-risk patients is associated with excellent immediate survival and is a valid alternative to TAVI in these patients.
2016
Aortic valve replacement; AVR; Perceval; Sutureless; TAVI; Transcatheter; Aged; Aged, 80 and over; Aortic Valve; Aortic Valve Insufficiency; Aortic Valve Stenosis; Bioprosthesis; Chi-Square Distribution; Europe; Female; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Hospital Mortality; Humans; Logistic Models; Male; Multivariate Analysis; Propensity Score; Prosthesis Design; Retrospective Studies; Risk Factors; Time Factors; Treatment Outcome; Cardiac Catheterization; Sutureless Surgical Procedures; Cardiology and Cardiovascular Medicine
01 Pubblicazione su rivista::01a Articolo in rivista
Immediate outcome after sutureless versus transcatheter aortic valve replacement / Biancari, Fausto; Barbanti, Marco; Santarpino, Giuseppe; Deste, Wanda; Tamburino, Corrado; Gulino, Simona; Immè, Sebastiano; Di Simone, Emanuela; Todaro, Denise; Pollari, Francesco; Fischlein, Theodor; Kasama, Keiichiro; Meuris, Bart; Dalén, Magnus; Sartipy, Ulrik; Svenarud, Peter; Lahtinen, Jarmo; Heikkinen, Jouni; Juvonen, Tatu; Gatti, Giuseppe; Pappalardo, Aniello; Mignosa, Carmelo; Rubino, Antonino S.. - In: HEART AND VESSELS. - ISSN 0910-8327. - STAMPA. - 31:3(2016), pp. 427-433. [10.1007/s00380-014-0623-3]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1018219
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