A comparison of conventional surgery, transcatheter aortic valve replacement, and sutureless valves in "real-world" patients with aortic stenosis and intermediate- to high-risk profile Read at the 95th Annual Meeting of the American Association for Thoracic Surgery, Seattle, Washington, April 25-29, 2015.

Claudio Muneretto, Ottavio Alfieri, Bruno Mario Cesana, Gianluigi Bisleri, Michele De Bonis, Roberto Di Bartolomeo, Carlo Savini, Gianluca Folesani, Lorenzo Di Bacco, Manfredo Rambaldini, Juan Pablo Maureira, Francois Laborde, Maurizio Tespili, Alberto Repossini, Thierry Folliguet

Research output: Contribution to journalArticle

Abstract

Objective We sought to investigate the clinical outcomes of patients with isolated severe aortic stenosis and an intermediate- to high-risk profile treated by means of conventional surgery (surgical aortic valve replacement), sutureless valve implantation, or transcatheter aortic valve replacement in a multicenter evaluation. Methods Among 991 consecutive patients with isolated severe aortic stenosis and an intermediate- to high-risk profile (Society of Thoracic Surgeons score >4 and logistic European System for Cardiac Operative Risk Evaluation I >10), a propensity score analysis was performed on the basis of the therapeutic strategy: surgical aortic valve replacement (n = 204), sutureless valve implantation (n = 204), and transcatheter aortic valve replacement (n = 204). Primary end points were 30-day mortality and overall survival at 24-month follow-up; the secondary end point was survival free from a composite end point of major adverse cardiac events (defined as cardiac-related mortality, myocardial infarction, cerebrovascular accidents, and major hemorrhagic events) and periprosthetic regurgitation greater than 2. Results Thirty-day mortality was significantly higher in the transcatheter aortic valve replacement group (surgical aortic valve replacement = 3.4% vs sutureless = 5.8% vs transcatheter aortic valve replacement = 9.8%; P =.005). The incidence of postprocedural was 3.9% in asurgical aortic valve replacement vs 9.8% in sutureless vs 14.7% in transcatheter aortic valve replacement (P

Original languageEnglish
Pages (from-to)1570-1579
Number of pages10
JournalJournal of Thoracic and Cardiovascular Surgery
Volume150
Issue number6
DOIs
Publication statusPublished - Dec 1 2015

Keywords

  • aortic valve replacement
  • sutureless bioprosthesis
  • transcatheter valve implantation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine
  • Medicine(all)

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