Journal article

Publication year: 2018

Pages: 667-675

Journal: European Heart Journal

Volume number: 39

Issue number: 8

ISSN: 0195-668X

eISSN: 1522-9645

Open access status: Hybrid

DOI Link: https://doi.org/10.1093/eurheartj/ehx688

Publisher: Oxford University Press

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 (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.

Harvard Citation style: Gaede, L., Blumenstein, J., Liebetrau, C., Doerr, O., Kim, W., Nef, H., et al. (2018) Outcome after transvascular transcatheter aortic valve implantation in 2016, European Heart Journal, 39(8), pp. 667-675. https://doi.org/10.1093/eurheartj/ehx688

APA Citation style: Gaede, L., Blumenstein, J., Liebetrau, C., Doerr, O., Kim, W., Nef, H., Husser, O., Elsaesser, A., Hamm, C., & Moellmann, H. (2018). Outcome after transvascular transcatheter aortic valve implantation in 2016. European Heart Journal. 39(8), 667-675. https://doi.org/10.1093/eurheartj/ehx688