ISSN 2996-8215
International Journal of Cardiology | Vol. 1, No. 5, May 2010 | pp. 33–40
DOI: 10.46882/2010/IJC/000014
Original Research Article
Transcatheter Aortic Valve Implantation versus Surgical Aortic Valve Replacement in High-Risk Elderly Patients: A Single-Center Experience
Jean-Pierre Dubois¹, Lucia Rossi², Pierre Vigneron¹
¹Department of Interventional Cardiology, Hôpital Européen Georges-Pompidou, Paris, France
²Department of Cardiac Surgery, University of Milan, Milan, Italy
Abstract:
Transcatheter aortic valve implantation (TAVI) has emerged as an alternative therapy to surgical aortic valve replacement (SAVR) for severe symptomatic aortic stenosis in patients at high operative risk. This study compared the short- and mid-term clinical outcomes of elderly, high-risk patients treated with either TAVI or SAVR at our institution. We retrospectively evaluated 180 consecutive patients aged 80 years or older with severe aortic stenosis and a Logistic EuroSCORE greater than or equal to 15% who underwent TAVI (n = 90) or SAVR (n = 90) between 2007 and 2009. The primary baseline mean Logistic EuroSCORE was comparable between groups (TAVI: 22.4% ± 5.3% vs. SAVR: 21.8% ± 4.9%, p = 0.42). At 30 days post-procedure, all-cause mortality was 6.7% in the TAVI group and 8.9% in the SAVR group (p = 0.58). The incidence of major vascular complications (11.1% vs. 2.2%, p = 0.02) and new permanent pacemaker implantation (15.6% vs. 4.4%, p = 0.01) was significantly higher in the TAVI group. Conversely, severe bleeding requiring blood transfusions (20.0% vs. 42.2%, p = 0.001) and acute kidney injury (4.4% vs. 13.3%, p = 0.04) were more frequent after SAVR. At 1-year follow-up, survival rates were similar between TAVI and SAVR (81.1% vs. 78.9%, log-rank p = 0.70). Both modalities demonstrated marked improvements in New York Heart Association functional class. In high-risk elderly patients, TAVI yields mid-term survival rates comparable to SAVR, with distinct periprocedural complication profiles.
Keywords: Aortic stenosis, Transcatheter aortic valve implantation, Surgical aortic valve replacement, High-risk patients, Mortality
Received: February 14, 2010; Revised: March 25, 2010; Accepted: April 10, 2010; Published: May 22, 2010
Citation: International Journal of Cardiology, 2010, Vol. 1, No. 5, pp. 33–40, DOI: 10.46882/2010/IJC/000014