One year Post-Intervention Mortality Rate: TAVR and AVR – Aortic Valve Procedures 6.7% in AVR, 11.0% in AVR with CABG, 20.7 in Transvascular (TV-TAVT) and 28.0% in Transapical (TA-TAVR) Patients
Reporter: Aviva Lev-Ari, PhD, RN
UPDATED on 4/8/2017
Reporter, MedPage Today/CRTonline.org, April 03, 2017
Clinical transcatheter heart valve thrombosis may be common enough to merit routine imaging after transcatheter aortic valve replacement (TAVR), a German study suggested.
A retrospective analysis of a single-center registry found a 2.8% incidence of clinical valve thrombosis, according to Mohamed Abdel-Wahab, MD, of Germany’s Segeberger Kliniken, and colleagues. No one on oral anticoagulation got bioprosthetic valve thrombosis, however, and no patients died from it.
Thrombosis was more likely with balloon-expandable valves (OR 3.45, 95% CI 1.22-9.81) and with valve-in-valve procedures (OR 5.93, 95% CI 2.01-17.51), the authors reported in the April 10 issue of JACC: Cardiovascular Interventions.
One year Post-Intervention Mortality Rate: TAVR and AVR – Aortic Valve Procedures 6.7% in AVR, 11.0% in AVR with CABG, 20.7 in Transvascular (TV-TAVR) and 28.0% in Transapical (TA-TAVR) Patients
RESULTS
The 1-year mortality rate was
- 6.7% for conventional AVR patients (n = 6523) and
- 11.0% for patients who underwent AVR with coronary artery bypass grafting (n = 3464).
- The 1-year mortality rate was 20.7 and 28.0% in TV- and TA-TAVR patients, respectively (n = 2695 and 1181).
However, if patients were stratified into four risk groups by means of the EuroSCORE and the German AV Score, the
- highest risk cohorts showed the same mortality at 1 year with either therapy.
- More than 80% of patients in all groups were in the same or better state of health at 1 year post-intervention and were satisfied with the procedural outcome.
European Journal of Cardio-Thoracic Surgery
Eur J Cardiothorac Surg (2014)doi: 10.1093/ejcts/ezu290
http://ejcts.oxfordjournals.org/content/early/2014/07/24/ejcts.ezu290.full
The German Aortic Valve Registry: 1-year results from 13 680 patients with aortic valve disease†
- Friedrich W. Mohra,*,
- David Holzheya,
- Helge Möllmannb,
- Andreas Beckmannc,
- Christof Veitd,
- Hans Reiner Figullae,
- Jochen Cremerf,
- Karl-Heinz Kuckg,
- Rüdiger Langeh,
- Ralf Zahni,
- Stefan Sackj,
- Gerhard Schulera,
- Thomas Waltherk,
- Friedhelm Beyersdorfl,
- Michael Böhmm,
- Gerd Heuschn,
- Anne-Kathrin Funkata,
- Thomas Meinertzo,
- Till Neumannp,
- Konstantinos Papoutsisq,
- Steffen Schneiderr,
- Armin Welzs and
- Christian W. Hammb
- for the GARY Executive Board
+Author Affiliations
- ↵*Corresponding author. Heart Center Leipzig, Struempellstrasse 39, 04289 Leipzig, Germany. Tel: +49-341-8651421; fax: +49-341-8651452; e-mail:mohrf@medizin.uni-leipzig.de, friedrich.mohr@herzzentrum-leipzig.de (F.W. Mohr).
-
↵† An excerpt of the 1-year data was first presented at the ACC in San Francisco in March 2013.
- Received April 16, 2014.
- Revision received May 27, 2014.
- Accepted June 17, 2014.
Abstract
OBJECTIVES The German Aortic Valve Registry (GARY) seeks to provide information on a real-world, all-comers basis for patients undergoing aortic valve interventions. This registry comprises patients undergoing the complete spectrum of transcutaneous and conventional surgical aortic valve interventions. The aim of this study was to use the GARY registry to evaluate conventional and catheter-based aortic valve interventions in several risk groups.
METHODS A total of 13 860 consecutive patients undergoing intervention for aortic valve disease [conventional aortic valve replacement (AVR) or transvascular/transapical TAVR (TV-/TA-TAVR)] were enrolled in 78 German centres in 2011. Baseline, procedural and outcome data, including quality of life, were acquired up to 1 year post-intervention. Vital status at 1 year was known for 98.1% of patients.
RESULTS The 1-year mortality rate was 6.7% for conventional AVR patients (n = 6523) and 11.0% for patients who underwent AVR with coronary artery bypass grafting (n = 3464). The 1-year mortality rate was 20.7 and 28.0% in TV- and TA-TAVR patients, respectively (n = 2695 and 1181). However, if patients were stratified into four risk groups by means of the EuroSCORE and the German AV Score, the highest risk cohorts showed the same mortality at 1 year with either therapy. More than 80% of patients in all groups were in the same or better state of health at 1 year post-intervention and were satisfied with the procedural outcome.
CONCLUSIONS Conventional AVR surgery yields excellent results after 1 year in lower-risk patients. Catheter-based AVR is a good alternative in high-risk and elderly patients.
Key words
- Aortic valve interventions
- Risk groups
- One-year mortality
- Aortic valve registry
- Catheter-based valve replacement
- © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
SOURCE
http://ejcts.oxfordjournals.org/content/early/2014/07/24/ejcts.ezu290.abstract
Leave a Reply