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53. Surgical and transcatheter aortic valve procedures. The limits of risk scores.

Author

Ranucci, Marco, Guarracino, Fabio, Castelvecchio, Serenella, Baldassarri, Rubia, Covello, Remo Daniel, and Landoni, Giovanni

Abstract

Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement in very high-risk patients with severe aortic stenosis. The present multicenter, retrospective study investigates the accuracy and calibration properties of the EuroSCORE and the age, serum creatinine, and ejection fraction (ACEF) score in selecting a population of patients to be referred to TAVI. The study includes 1053 surgical and 211 transcatheter procedures. The operative mortality rate within the surgical group was 2%. The EuroSCORE and the ACEF score had similar levels of accuracy; the ACEF score was well calibrated and the EuroSCORE overestimated the mortality risk. The observed mortality rate within the transcatheter group was 10.4%. Cut-off values corresponding to a mortality rate of 10% were 26 for the logistic EuroSCORE and 2.5 for the ACEF score: both the EuroSCORE and the ACEF score may be used to refer patients to TAVI. However, they do not consider a number of 'extreme' risk conditions that may justify a transcatheter procedure even in absence of an overall elevated risk score. These risk conditions should be included in a specific risk model for referring patients for TAVI.

Published
2010
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54. 1-Year Outcomes After Transfemoral Transcatheter or Surgical Aortic Valve Replacement Results From the Italian OBSERVANT Study

Author

Tamburino, Corrado, Barbanti, Marco, D'Errigo, Paola, Ranucci, Marco, Onorati, Francesco, Covello, Remo Daniel, Santini, Francesco, Rosato, Stefano, Santoro, Gennaro, Fusco, Danilo, Grossi, Claudio, and Seccareccia, Fulvia

Subjects
Aged, 80 and over, Heart Valve Prosthesis Implantation, Male, Time Factors, aortic stenosis, intermediate risk, Aortic Valve Stenosis, Transcatheter Aortic Valve Replacement, Treatment Outcome, Italy, transcatheter aortic valve, 80 and over, Humans, Female, implantation, Prospective Studies, Mortality, Aged, Follow-Up Studies
Abstract

BackgroundThere is a paucity of prospective and controlled data on the comparative effectiveness of transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in a real-world setting.ObjectivesThis analysis aims to describe 1-year clinical outcomes of a large series of propensity-matched patients who underwent SAVR and transfemoral TAVR.MethodsThe OBSERVANT (Observational Study of Effectiveness of SAVR–TAVI Procedures for Severe Aortic Stenosis Treatment) trial is an observational prospective multicenter cohort study that enrolled patients with aortic stenosis (AS) who underwent SAVR or TAVR. The propensity score method was applied to select 2 groups with similar baseline characteristics. All outcomes were adjudicated through a linkage with administrative databases. The primary endpoints of this analysis were death from any cause and major adverse cardiac and cerebrovascular events (MACCE) at 1 year.ResultsThe unadjusted enrolled population (N = 7,618) included 5,707 SAVR patients and 1,911 TAVR patients. The matched population had a total of 1,300 patients (650 per group). The propensity score method generated a low-intermediate risk population (mean logistic EuroSCORE 1: 10.2 ± 9.2% vs. 9.5 ± 7.1%, SAVR vs. transfemoral TAVR; p = 0.104). At 1 year, the rate of death from any cause was 13.6% in the surgical group and 13.8% in the transcatheter group (hazard ratio [HR]: 0.99; 95% confidence interval [CI]: 0.72 to 1.35; p = 0.936). Similarly, there were no significant differences in the rates of MACCE, which were 17.6% in the surgical group and 18.2% in the transcatheter group (HR: 1.03; 95% CI: 0.78 to 1.36; p = 0.831). The cumulative incidence of cerebrovascular events, and rehospitalization due to cardiac reasons and acute heart failure was similar in both groups at 1 year.ConclusionsThe results suggest that SAVR and transfemoral TAVR have comparable mortality, MACCE, and rates of rehospitalization due to cardiac reasons at 1 year. These data need to be confirmed in longer term and dedicated ongoing randomized trials.

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55. Different impact of sex on baseline characteristics and major periprocedural outcomes of transcatheter and surgical aortic valve interventions: Results of the multicenter Italian OBSERVANT Registry

Author

Onorati, Francesco, D'Errigo, Paola, Barbanti, Marco, Rosato, Stefano, Covello, Remo Daniel, Maraschini, Alice, Ranucci, Marco, Santoro, Gennaro, Tamburino, Corrado, Grossi, Claudio, Santini, Francesco, Menicanti, Lorenzo, Seccareccia, Fulvia, Badoni, Gabriella, Fusco, Danilo, De Palma, Rossana, Scondotto, Salvatore, Orlando, Anna, Copello, Francesco, Zanier, Loris, Zocchetti, Carlo, Cecchi, Mario, Borgia, Piero, Celentano, Egidio, Mauro, Aldo, De Luca, Giovanni, Marchetta, Fausto, Antonelli, Antonello, Porcu, Rosanna, Marra, S., D'Amico, M., Gaita, F., Moretti, C., De Benedictis, M., Aranzulla, T., Pistis, G., Reale, M., Bedogni, F., Brambilla, N., Colombo, A., Chieffo, A., Ferrari, A., Inglese, L., Casilli, F., Ettori, F., Frontini, M., Antona, C., Piccaluga, E., Klugmann, S., De Marco, F., Tespili, M., Saino, A., Franceschini Grisolia, E., Isabella, G., Fraccaro, C., Proclemer, A., Bisceglia, T., Armellini, I., Vischi, M., Parodi, E., Petronio, S., Giannini, C., Pierli, C., Iadanza, A., Santoro, G., Meucci, F., Tomai, F., Ghini, A., Sardella, Gennaro, Mancone, M., Ribichini, F., Vassanelli, C., Dandale, R., Giudice, P., Vigorito, F., Bortone, A., De Luca Tupputi Schinosa, L., De Cillis, E., Indolfi, C., Spaccarotella, C., Stabile, A., Gandolfo, C., Tamburino, C., Ussia, G., Rinaldi, M., Salizzoni, S., Grossi, C., Di Gregorio, O., Scoti, P., Costa, R., Casabona, R., Del Ponte, S., Panisi, P., Spira, G., Troise, G., Messina, A., Viganò, M., Aiello, M., Alfieri, O., Denti, P., Menicanti, L., Agnelli, B., Muneretto, C., Rambaldini, M., Gamba, A., Tasca, G., Ferrazzi, P., Terzi, A., Gelpi, G., Martinelli, L., Bruschi, G., Graffigna, A. C., Mazzucco, A., Pappalardo, A., Gatti, G., Livi, U., Pompei, E., Passerone, G., Bortolotti, U., Pratali, S., Stefano, P., Blanzola, C., Glauber, M., Cerillo, A., Chiaramonti, F., Pardini, A., Fioriello, F., Torracca, L., Rescigno, G., De Paulis, R., Nardella, S., Musumeci, F., Luzi, G., Possati, G., Bonalumi, G., Covino, E., Pollari, F., Sinatra, Riccardo, Roscitano, A., Chiariello, L., Nardi, P., Lonobile, T., Baldascino, F., Di Benedetto, G., Mastrogiovanni, G., Piazza, L., Marmo, J., Vosa, C., De Amicis, V., Villani, M., Pano, M. A., Cassese, M., Antonazzo, A., Patanè, L., Gentile, M., Tribastone, S., Follis, F., Montalbano, G., Pilato, M., Stringi, V., Patanè, F., Salamone, G., Ruvolo, G., Pisano, C., Mignosa, C., Bivona, A., Cirio, E. M., Lixi, G., Onorati, F., D'Errigo, P., Barbanti, M., Rosato, S., Covello, R. D., Maraschini, A., Ranucci, M., Santoro, G., Tamburino, C., Grossi, C., Santini, F., Menicanti, L., Seccareccia, F., Badoni, G., Fusco, D., De Palma, R., Scondotto, S., Orlando, A., Copello, F., Zanier, L., Zocchetti, C., Cecchi, M., Borgia, P., Celentano, E., Mauro, A., De Luca, G., Marchetta, F., Antonelli, A., Porcu, R., Marra, S., D'Amico, M., Gaita, F., Moretti, C., De Benedictis, M., Aranzulla, T., Pistis, G., Reale, M., Bedogni, F., Brambilla, N., Colombo, A., Chieffo, A., Ferrari, A., Inglese, L., Casilli, F., Ettori, F., Frontini, M., Antona, C., Piccaluga, E., Klugmann, S., De Marco, F., Tespili, M., Saino, A., Franceschini Grisolia, E., Isabella, G., Fraccaro, C., Proclemer, A., Bisceglia, T., Armellini, I., Vischi, M., Parodi, E., Petronio, S., Giannini, C., Pierli, C., Iadanza, A., Meucci, F., Tomai, F., Ghini, A., Sardella, G., Mancone, M., Ribichini, F., Vassanelli, C., Dandale, R., Giudice, P., Vigorito, F., Bortone, A., De Luca Tupputi Schinosa, L., De Cillis, E., Indolfi, C., Spaccarotella, C., Stabile, A., Gandolfo, C., Ussia, G., Rinaldi, M., Salizzoni, S., Di Gregorio, O., Scoti, P., Costa, R., Casabona, R., Del Ponte, S., Panisi, P., Spira, G., Troise, G., Messina, A., Vigano, M., Aiello, M., Alfieri, O., Denti, P., Agnelli, B., Muneretto, C., Rambaldini, M., Gamba, A., Tasca, G., Ferrazzi, P., Terzi, A., Gelpi, G., Martinelli, L., Bruschi, G., Graffigna, A. C., Pappalardo, A., Mazzucco, A., Livi, U., Pompei, E., Passerone, G., Bortolotti, U., Pratali, S., Stefano, P., Blanzola, C., Glauber, M., Cerillo, A., Chiaramonti, F., Pardini, A., Fioriello, F., Torracca, L., Rescigno, G., De Paulis, R., Nardella, S., Musumeci, F., Luzi, G., Possati, G., Bonalumi, G., Covino, E., Pollari, F., Sinatra, R., Roscitano, A., Chiariello, L., Nardi, P., Lonobile, T., Baldascino, F., Di Benedetto, G., Mastrogiovanni, G., Piazza, L., Marmo, J., Vosa, C., De Amicis, V., Villani, M., Pano, M. A., Cassese, M., Antonazzo, A., Patane, L., Gentile, M., Tribastone, S., Montalbano, G., Follis, F., Pilato, M., Stringi, V., Patane, F., Salamone, G., Ruvolo, G., Pisano, C., Mignosa, C., Bivona, A., Cirio, E. M., and Lixi, G.

Subjects
Aortic valve, Registrie, Age Factors, Aged, Aged, 80 and over, Aortic Valve, Aortic Valve Stenosis, Blood Transfusion, Chi-Square Distribution, Comorbidity, Female, Heart Valve Prosthesis Implantation, Hospital Mortality, Humans, Italy, Linear Models, Logistic Models, Male, Multivariate Analysis, Odds Ratio, Postoperative Complications, Prospective Studies, Registries, Risk Assessment, Risk Factors, Severity of Illness Index, Sex Factors, Time Factors, Treatment Outcome, Cardiac Catheterization, Health Status Disparities, Surgery, Medicine (all), Pulmonary and Respiratory Medicine, Cardiology and Cardiovascular Medicine, medicine.medical_treatment, Sex Factor, Aortic valve replacement, 80 and over, Age Factor, Myocardial infarction, Multivariate Analysi, education.field_of_study, Ejection fraction, medicine.anatomical_structure, Aortic valve stenosis, Cardiology, Linear Model, Human, medicine.medical_specialty, Logistic Model, Time Factor, Population, Internal medicine, medicine, education, business.industry, Risk Factor, Percutaneous coronary intervention, Settore MED/23 - Chirurgia Cardiaca, EuroSCORE, medicine.disease, Aortic Valve Stenosi, Prospective Studie, Postoperative Complication, business
Abstract

Background: Despite the widespread use of transcatheter aortic valve implantation (TAVI), the role of sex on outcome after TAVI or surgical aortic valve replacement (AVR) has been poorly investigated. We investigated the impact of sex on outcome after TAVI or AVR. Methods: There were 2108 patients undergoing TAVI or AVR who were enrolled in the Italian Observational Multicenter Registry (OBSERVANT). Thirty-day mortality, major periprocedural morbidity, and transprosthetic gradients were stratified by sex according to interventions. Results: Female AVR patients showed a worse risk profile compared with male AVR patients, given the higher mean age, prevalence of frailty score of 2 or higher, New York Heart Association class of 3 or higher, lower body weight, and preoperative hemoglobin level (P ≤.02). Similarly, female TAVI patients had a different risk profile than male TAVI patients, given a higher age and a lower body weight and preoperative hemoglobin level (P ≤.005), but with a similar New York Heart Association class, frailty score, EuroSCORE (P = NS), a better left ventricular ejection fraction and a lower prevalence of left ventricular ejection fraction less than 30%, porcelain aorta, renal dysfunction, chronic obstructive pulmonary disease, arteriopathy, and previous cardiovascular surgery or percutaneous coronary intervention (P ≤.01). Women showed a smaller aortic annulus than men in both populations (P

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56. Melatonin as adjuvant treatment in COVID-19 patients. A meta-analysis of randomized and propensity matched studies.

Author

Tóth, Krisztina, Pilia, Eros, Landoni, Giovanni, Oreggia, Davide, Giacomarra, Salvatore, Losiggio, Rosario, Maiucci, Giacomo, Vlasakov, Iliyan, Yavorovskiy, Andrey, Likhvantsev, Valery, Székely, Andrea, and Covello, Remo Daniel

Subjects
*COVID-19, *COVID-19 treatment, *CORONAVIRUS disease treatment, *MELATONIN, *SCIENTIFIC language
Abstract

Melatonin is a neurohormone well-known as sleep disorder treatment. A few clinical trials have recently pointed out the biological plausibility of utilising melatonin in the treatment of coronavirus disease 2019 (COVID-19, SARS-CoV-2) patients. Melatonin wide range of activities include anti-inflammatory, antiviral and antioxidant effects. Our meta-analysis aimed to investigate the effect of melatonin on mortality in COVID19 patients with different disease severity. We searched PubMed, EMBASE, Web of Science with no language restrictions updated on February 2023 for randomized and propensity matched studies, comparing melatonin plus standard COVID-19 therapy vs. standard COVID-19 therapy alone. Patients had to be hospitalised with a confirmed diagnosis of SARS-CoV-2 infection. Primary outcome was mortality at the longest follow-up available. We included 7 randomized and 1 propensity matched studies enrolling 1155 overall patients with a mean age of 61 ± 19.5 years. We found a reduced mortality rate in the overall population (127/575 (22%) vs. 209/580 (36%) Relative Risk: 0.62 (confidence interval (CI): 0.40, 0.96), I2 = 86% p = 0.03, with the results confirmed when pooling the 5 studies which administered melatonin in non-intensivecare-unit patients (26/423 (6.1%) vs. 69/419 (16%) Relative Risk 0.30 (CI: 0.10, 0.86), I 2 = 40% p = 0.02). According to recent randomized and propensity matched evidence, melatonin might be a life-saving adjuvant therapy in COVID-19 patients. This effect was mainly driven by non-intensive care unit patients. [ABSTRACT FROM AUTHOR]

Published
2024
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57. Nonsurgical Strategies to Reduce Mortality in Patients Undergoing Cardiac Surgery: An Updated Consensus Process

Author

Miriam Labonia, Rosalba Lembo, Cristiano Amarelli, Giuseppe Bono, Remo Daniel Covello, Nora Di Tomasso, Daniela Pasero, Hynek Riha, Anna Mara Scandroglio, Claudio Riefolo, Nesrin Ahu Aslan, Carlo Leggieri, Rosetta Lobreglio, Giovanni Landoni, Valery V. Likhvantsev, Vladimir V. Lomivorotov, Gabriele Alvaro, Ludmilla Abrahao Hajjar, Alberto Zangrillo, Chiara Sartini, Martina Baiardo Redaelli, Massimo Baiocchi, Fabrizio Monaco, Giacomo Monti, Carmine D. Votta, Valentina Camarda, Paolo Mura, Evgeny Fominskiy, Alessandro Putzu, Emanuela Saporito, Antonio Pisano, Gianluca Paternoster, Rinaldo Bellomo, Simona Silvetti, Luca Brazzi, Giovanni Affronti, Stefano Turi, Agostino Roasio, Andrea Székely, Jun Ma, Caetano Nigro Neto, Landoni, Giovanni, Lomivorotov, Vladimir, Silvietti, Simona, Nigro Neto, Caetano, Pisano, Antonio, Alvaro, Gabriele, Hajjar, Ludmilla Abrahao, Paternoster, Gianluca, Riha, Hynek, Monaco, Fabrizio, Szekely, Andrea, Lembo, Rosalba, Aslan, Nesrin A., Affronti, Giovanni, Likhvantsev, Valery, Amarelli, Cristiano, Fominskiy, Evgeny, Baiardo Redaelli, Martina, Putzu, Alessandro, Baiocchi, Massimo, Ma, Jun, Bono, Giuseppe, Camarda, Valentina, Covello, Remo Daniel, Di Tomasso, Nora, Labonia, Miriam, Leggieri, Carlo, Lobreglio, Rosetta, Monti, Giacomo, Mura, Paolo, Scandroglio, Anna Mara, Pasero, Daniela, Turi, Stefano, Roasio, Agostino, Votta, Carmine D., Saporito, Emanuela, Riefolo, Claudio, Sartini, Chiara, Brazzi, Luca, Bellomo, Rinaldo, and Zangrillo, Alberto

Subjects
medicine.medical_specialty, Consensus, Cardiac Surgery, Consensus Development Conferences as Topic, Psychological intervention, MEDLINE, Consensu, Review, 030204 cardiovascular system & hematology, Perioperative Care, law.invention, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Randomized controlled trial, law, Anesthesiology, Intensive care, medicine, Humans, 030212 general & internal medicine, Perioperative, Cardiac Surgical Procedures, Mortality, Intensive care medicine, cardiac surgery, consensus, mortality, mortality reduction, perioperative, review, Cardiology and Cardiovascular Medicine, Anesthesiology and Pain Medicine, Randomized Controlled Trials as Topic, Internet, business.industry, Congresses as Topic, Cardiac surgery, Mortality reduction, Bypass surgery, TERAPÊUTICA MÉDICA, business, Mortality Reduction
Abstract

Objective: A careful choice of perioperative care strategies is pivotal to improve survival in cardiac surgery. However, there is no general agreement or particular attention to which nonsurgical interventions can reduce mortality in this setting. The authors sought to address this issue with a consensus-based approach. Design: A systematic review of the literature followed by a consensus-based voting process. Setting: A web-based international consensus conference. Participants: More than 400 physicians from 52 countries participated in this web-based consensus conference. Interventions: The authors identified all studies published in peer-reviewed journals that reported on interventions with a statistically significant effect on mortality in the setting of cardiac surgery through a systematic Medline/PubMed search and contacts with experts. These studies were discussed during a consensus meeting and those considered eligible for inclusion in this study were voted on by clinicians worldwide. Measurements and Main Results: Eleven interventions finally were selected: 10 were shown to reduce mortality (aspirin, glycemic control, high-volume surgeons, prophylactic intra-aortic balloon pump, levosimendan, leuko-depleted red blood cells transfusion, noninvasive ventilation, tranexamic acid, vacuum-assisted closure, and volatile agents), whereas 1 (aprotinin) increased mortality. A significant difference in the percentages of agreement among different countries and a variable gap between agreement and clinical practice were found for most of the interventions. Conclusions: This updated consensus process identified 11 nonsurgical interventions with possible survival implications for patients undergoing cardiac surgery. This list of interventions may help cardiac anesthesiologists and intensivists worldwide in their daily clinical practice and can contribute to direct future research in the field. Orion Pharma ; Abbott Laboratories ; Pall ; Tenax

Published
2018

58. Outcome After General Anesthesia Versus Monitored Anesthesia Care in Transfemoral Transcatheter Aortic Valve Replacement.

Author

D'Errigo P, Ranucci M, Covello RD, Biancari F, Rosato S, Barbanti M, Onorati F, Tamburino C, Santoro G, Grossi C, Santini F, Bontempi K, Fusco D, and Seccareccia F

Subjects
Aged, 80 and over, Cohort Studies, Female, Humans, Italy, Length of Stay, Male, Propensity Score, Prospective Studies, Survival Rate, Treatment Outcome, Anesthesia, General methods, Anesthesia, Local methods, Monitoring, Intraoperative methods, Transcatheter Aortic Valve Replacement
Abstract

Objective: To evaluate outcomes of monitored anesthesia care (MAC) compared with general anesthesia (GA) in patients undergoing transfemoral transcatheter aortic valve replacement (TAVR)., Design: Secondary analysis from the observational and prospective OBSERVANT (OBservational Study of Effectiveness of avR-taVi procedures for severe Aortic steNosis Treatment) study., Setting: Multicenter study, including Italian hospitals performing TAVR interventions., Participants: One thousand four hundred ninety-four patients with severe and symptomatic aortic stenosis., Interventions: Transfemoral TAVR under general or local anesthesia., Measurements and Main Results: A propensity score procedure was applied, and 310 pairs were matched with similar baseline characteristics (EuroSCORE II: local anesthesia 6.6±5.9% v general anesthesia 7.0±7.7%, p = 0.430). MAC was associated with similar 30-day mortality compared with GA (3.9% v 4.8%, p = 0.564). TAVR was performed under MAC without any increased risk of other adverse events. The risk of paravalvular regurgitation≥mild was similar between the study groups (MAC 49.5% v general anesthesia 57.0%, p = 0.858). Two patients receiving on MAC had severe paravalvular regurgitation, whereas this complication was not observed after GA. Permanent pacemaker implantation was 19.1% in the MAC group v 14.8% in the GA group (p = 0.168). Mean intensive care unit stay was 3.5 days for the GA group v 2.9 days for the MAC group (p = 0.086). A similar 3-year survival rate was observed (MAC 69.4% v GA 69.9%, p = 0.966)., Conclusions: Transfemoral TAVR can be performed under MAC with similar immediate and late outcomes as compared with GA. A possible risk of severe paravalvular regurgitation and pacemaker implantation with TAVR under MAC requires further investigation., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Published
2016
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60. [Results of the OBSERVANT study: clinical characteristics and short-term outcome of the enrolled population treated with transcatheter versus surgical aortic valve implantation].

Author

D'Errigo P, Barbanti M, Santini F, Grossi C, Ranucci M, Onorati F, Covello RD, Rosato S, Tamburino C, Santoro G, Fusco D, and Seccareccia F

Subjects
Aged, Aged, 80 and over, Catheters, Female, Humans, Male, Prospective Studies, Time Factors, Treatment Outcome, Aortic Valve surgery, Aortic Valve Stenosis surgery, Heart Valve Prosthesis Implantation methods
Abstract

Background: OBSERVANT represents the first national observational study on the comparative effectiveness of transcatheter aortic valve implantation (TAVI) vs surgical aortic valve replacement (SAVR) at short, medium and long term, in a patient population with severe aortic stenosis (AS). The aim of this paper is to describe patient characteristics and short-term outcomes of the enrolled population., Methods: OBSERVANT is an observational prospective multicenter cohort study that enrolled AS patients undergoing SAVR or TAVI from December 2010 to June 2012 in the participating hospitals. Information on demographic characteristics, health status prior to intervention, therapeutic approach, intraprocedural and 30-day outcomes was collected. An administrative follow-up was set up to collect data on long-term outcomes., Results: The enrolled population included 7618 patients undergoing transfemoral/transubclavian TAVI (TF/TS-TAVI, n=1652), transapical TAVI (TA-TAVI, n=259) or SAVR (n=5707). SAVR patients were younger and with a lower risk profile than TAVI patients (logistic EuroSCORE: SAVR 6.4 ± 7.3%, TF/TS-TAVI 14.1 ± 12.1%, TA-TAVI 15.5 ± 11.0%; p<0.001). When 30-day mortality rates were stratified by logistic EuroSCORE, a statistically significant difference was found only in the patient subgroup with logistic EuroSCORE ≤5% (SAVR 1.0%, TF/TS-TAVI 4.7%, TA-TAVI 0.0%; p=0.005)., Conclusions: Findings from the OBSERVANT study confirm that patients undergoing TAVI are older and sicker than patients undergoing SAVR. Nevertheless, the logistic EuroSCORE shows that, in Italy, also patients at intermediate surgical risk are treated with TAVI. Stratifying by logistic EuroSCORE, SAVR seems to be superior to TAVI in the subgroup of patients at very low risk. More sophisticated analyses on patient subgroups with comparable risk profile and on long-term follow-up will allow to obtain valuable information on the effectiveness of TAVI and SAVR procedures.

Published
2014
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