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- Title
Outcome after transvascular transcatheter aortic valve implantation in 2016.
- Authors
Gaede, Luise; Blumenstein, Johannes; Liebetrau, Christoph; Dörr, Oliver; Kim, Won-Keun; Nef, Holger; Husser, Oliver; Elsässer, Albrecht; Hamm, Christian W; Möllmann, Helge
- Abstract
Aims We analysed the number of procedures, complications and in-hospital mortality rates of all patients undergoing transvascular transcatheter aortic valve implantation (TV-TAVI) in comparison to isolated surgical aortic valve replacement (iSAVR) from 2014 to 2016 in Germany. Methods and results All aortic valve procedures performed in Germany are mandatorily registered in a quality control program. More than 15 000 TV-TAVI procedures were performed in 2016 in Germany. Especially the number of post-procedural complications declined within the last few years, including new pacemaker implantations (2015: 12.6% vs. 2016: 11.4%, P=0.002) and vascular complications (2015: 8.5% vs. 2016: 7.1%; P< 0.001). Thus, in 2016 the overall in-hospital mortality rate after TV-TAVI was 2.6%, which is for the first time numerically below that of iSAVR, which was 2.9% (P=0.19). A stratified analysis according to the German aortic valve score shows a lower observed than expected in-hospital mortality rate for TV-TAVI (O/E 0.68). Additionally, the in-hospital mortality was significantly lower after TV-TAVI than after iSAVR in the very high- (11.3% vs. 23.6%; P< 0.001), in the high- (4.1% vs. 9.2%; P< 0.001) and in the intermediate-risk group (3.0% vs. 4.6%; P= 0.016) and was similar to that of iSAVR in low-risk patients (1.6% vs. 1.4%; P=0.4). Conclusion The overall in-hospital mortality after TV-TAVI was numerically lower than after iSAVR in 2016 for the first time. In the low risk group in-hospital mortality was similar, whereas in all other risk groups in-hospital mortality after TV-TAVI was significantly lower than after SAVR. This is likely to contribute to a redefinition of the standard of care in the future.
- Publication
European Heart Journal, 2018, Vol 39, Issue 8, p667
- ISSN
0195-668X
- Publication type
Article
- DOI
10.1093/eurheartj/ehx688