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Transcatheter versus surgical treatment for aortic stenosis: Patient selection and early outcome
Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Thoracic and Vascular Surgery in Östergötland. Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Thoracic Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Thoracic and Vascular Surgery in Östergötland.
Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Clinical Physiology UHL.
Linköping University, Department of Medical and Health Sciences, Thoracic Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Thoracic and Vascular Surgery in Östergötland.
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2012 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 46, no 5, 301-307 p.Article in journal (Refereed) Published
Abstract [en]

Objectives. To describe short-term clinical and echocardiography outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR). To explore patient selection criteria for treatment with TAVI. Design. TAVI patients (n = 45) were matched to SAVR patients (n = 45) with respect to age within +/- 10 years, sex and systolic left ventricular function. Results. TAVI patients were older, 82 +/- 8 versus 78 +/- 5 years (p = 0.005) and they had higher logEuroSCORE, 16 +/- 11% versus 8 +/- 4% (p andlt; 0.001). There were no significant differences in 30 days mortality, stroke and myocardial infarction. TAVI patients received less erythrocyte (53% vs. 78%, p = 0.03) and thrombocyte (7% vs. 27%, p = 0.02) transfusions. Postoperative atrial fibrillation was less common (18% vs. 60%, p andlt; 0.001) in the TAVI group. Paravalvular regurgitation was more common in TAVI patients (87% vs. 0%, p andlt; 0.001) and 27% had access site complications. Aortic transvalvular velocity was 2.3 +/- 0.4 m/s versus 2.6 +/- 0.5 m/s (p = 0.002) and mean valve pressure gradient was 12 +/- 4 mmHg versus 15 +/- 5 mmHg (p = 0.01) in the TAVI and SAVR groups, respectively. Twenty-nine (64%) of the TAVI patients had logEuroSCORE andlt; 15%. Conclusions. Both TAVI and SAVR have good short term clinical outcome with excellent hemodynamic result. In clinical practice, factors other than high logEuroSCORE play an important role in patient selection for TAVI.

Place, publisher, year, edition, pages
Informa Healthcare , 2012. Vol. 46, no 5, 301-307 p.
Keyword [en]
transcatheter aortic valve implantation, aortic valve replacement, outcome, echocardiography, patient selection
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-84532DOI: 10.3109/14017431.2012.699636ISI: 000308534400008OAI: oai:DiVA.org:liu-84532DiVA: diva2:560169
Note

Funding Agencies|Swedish Heart and Lung Foundation||Medical Research Council of Southeast Sweden (FORSS)||ALF||County Council of Ostergotland||

Available from: 2012-10-12 Created: 2012-10-12 Last updated: 2017-12-07

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Hultkvist, HenrikNylander, EvaAhn, Henrik CasimirNielsen, Niels ErikVánky, Farkas

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Department of Thoracic and Vascular Surgery in ÖstergötlandCardiologyFaculty of Health SciencesThoracic SurgeryClinical PhysiologyDepartment of Clinical Physiology UHLDepartment of Cardiology UHL
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