Journal article

Publication year: 2017

Pages: 411-419

Journal: Clinical Research in Cardiology

Volume number: 106

Issue number: 6

ISSN: 1861-0684

eISSN: 1861-0692

DOI Link: https://doi.org/10.1007/s00392-016-1070-1

Publisher: Springer

Abstract: 

We analysed the number of procedures, indications, and in-hospital mortality rates of all patients undergoing isolated surgical aortic valve replacement (sAVR) or transvascular (TV-) and transapical (TA-) transcatheter aortic valve implantation (TAVI) from 2012 to 2015 in Germany.

More than 31,000 aortic valve procedures were performed in 2015 in Germany, representing a total increase of 4.5% over 2014. TV-TAVI accounts for 13,108 of these procedures, with an increase of 21%, whereas the numbers of isolated sAVR and TA-TAVI decreased slightly. Age, frailty, high risk, and patients' choice were the main reasons for a catheter-based intervention. In 2015, the in-hospital mortality rate after TV-TAVI decreased to 3.4%, approaching that of sAVR (2.9%), despite a considerably higher baseline risk. A stratified analysis according to the German aortic valve (AKL) score demonstrated a further decrease of the in-hospital mortality for TV-TAVI, showing a lower in-hospital mortality rate than expected in all risk groups. Importantly, this also accounts for the lowest risk group with an AKL score < 3% showing an in-hospital mortality rate of 1.7%, which is now comparable to that of sAVR (1.5%). In all other risk groups, the in-hospital mortality in patients undergoing TV-TAVI was lower than in patients undergoing sAVR.

Mortality after TV-TAVI keeps decreasing over the last years and equals that of SAVR in the lowest risk cohort in the meanwhile. All TV-TAVI patients have significantly lower observed than expected mortality, which will further lead to a redefinition of standard of care.

Harvard Citation style: Gaede, L., Blumenstein, J., Kim, W., Liebetrau, C., Doerr, O., Nef, H., et al. (2017) Trends in aortic valve replacement in Germany in 2015: transcatheter versus isolated surgical aortic valve repair, Clinical Research in Cardiology, 106(6), pp. 411-419. https://doi.org/10.1007/s00392-016-1070-1

APA Citation style: Gaede, L., Blumenstein, J., Kim, W., Liebetrau, C., Doerr, O., Nef, H., Hamm, C., Elsaesser, A., & Moellmann, H. (2017). Trends in aortic valve replacement in Germany in 2015: transcatheter versus isolated surgical aortic valve repair. Clinical Research in Cardiology. 106(6), 411-419. https://doi.org/10.1007/s00392-016-1070-1