Early and Midterm Outcome of Propensity-Matched Intermediate-Risk Patients Aged ≥80 Years With Aortic Stenosis Undergoing Surgical or Transcatheter Aortic Valve Replacement (from the Italian Multicenter OBSERVANT Study)

Chiara Fraccaro, Giuseppe Tarantini, Stefano Rosato, Paola Tellaroli, Paola D'Errigo, Corrado Tamburino, Francesco Onorati, Marco Ranucci, Marco Barbanti, Claudio Grossi, Gennaro Santoro, Francesco Santini, Remo Daniel Covello, Danilo Fusco, Fulvia Seccareccia

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Abstract

The aim of this study was to analyze procedural and postprocedural outcomes of patients aged ≥80 years treated by transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR) as enrolled in the OBservational Study of Effectiveness of SAVR-TAVR procedures for severe Aortic steNosis Treatment (OBSERVANT) Study. TAVI is offered to patients with aortic stenosis judged inoperable or at high surgical risk. Nevertheless, it is common clinical practice to treat elderly (≥80 years) patients by TAVI regardless of surgical risk for traditional SAVR. OBSERVANT is a multicenter, observational, prospective cohort study that enrolled patients with symptomatic severe aortic stenosis who underwent SAVR or TAVI from December 2010 to June 2012 in 93 Italian participating hospitals. Information on demographic characteristics, health status before intervention, therapeutic approach, and intraprocedural and 30-day outcomes was collected. An administrative follow-up was set up to collect data on midterm to long-term outcomes. We reviewed baseline and procedural data of patients aged ≥80 years, looking for different early and late outcome after TAVI or SAVR. Patients treated by TAVI were sicker than SAVR because of higher rate of co-morbidities, advanced illness, frailty, and Logistic EuroSCORE. After propensity matching, early and midterm mortality were comparable between the 2 groups. However, patients treated by TAVI had higher rate of vascular complications (6.0% vs 0.5%; p

Original languageEnglish
JournalThe American Journal of Cardiology
DOIs
Publication statusAccepted/In press - Dec 6 2015

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Fraccaro, C., Tarantini, G., Rosato, S., Tellaroli, P., D'Errigo, P., Tamburino, C., Onorati, F., Ranucci, M., Barbanti, M., Grossi, C., Santoro, G., Santini, F., Covello, R. D., Fusco, D., & Seccareccia, F. (Accepted/In press). Early and Midterm Outcome of Propensity-Matched Intermediate-Risk Patients Aged ≥80 Years With Aortic Stenosis Undergoing Surgical or Transcatheter Aortic Valve Replacement (from the Italian Multicenter OBSERVANT Study). The American Journal of Cardiology. https://doi.org/10.1016/j.amjcard.2016.02.020