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| Transcatheter Aortic Valve Replacement in High-Risk Patients: Superior Results compared to Conventional Surgery | |
Robert Bauernschmitt, Domenico Mazzitelli, Christian Schreiber, Hendrik Ruge, Sabine Bleiziffer, Andrea Hutter, Peter Tassani, Ruediger Lange; Clinic for Cardiovascular Surgery, German Heart Center Munich, Munich, Germany
Methods: In 90 patients (mean age: 81.3 ± 7y, 48% female, mean logistic EuroScore 25 ± 15.6%), THV using vascular approach (femoral: 87, subclavian: 3) was performed between 7/2007 and 5/2008 using the 18-french-CoreValve system. Outcome data were compared to a patient cohort matched according to EuroScore values (mean age 78.8 ± 7.7y, 46% female) treated by conventional surgical aortic valve replacement (SAVR) with heart-lung machine performed by the same surgical team between 2001 and 2008. Results: Procedural success was 98% in patients undergoing THV. Early mortality (30d) was 6.6% in THV-patients vs. 17% in the SAVR-group (p<0.05), late mortality 8.8% vs. 12%. Postoperative stroke rate was comparable in both groups (THV: 5.5%, SAVR: 3%). New postoperative dialysis-dependent renal failure occurred in 20% of SAVR-patients, but only in 3.3% of THV-patients. Total AV-block requiring pacemaker implantation was more frequent in the THV-group (20.7% vs. 4%), the rate of postoperative myocardial infarctions was low in both groups (THV: 0, SAVR 2%). Conclusion: Except the higher rate of total AV-blocks, the early postoperative mortality and morbidity of THV is lower as compared to SAVR. While long-term results are still pending, we consider THV the treatment of choice in aged, high-risk patients with aortic stenosis. Back to 2009 Annual Meeting Back to Program Outline Back to Main Program |
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