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Minimally invasive aortic valve replacement with a sutureless valve through a right anterior mini-thoracotomy versus transcatheter aortic valve implantation in high-risk patients.
- Source :
-
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2016 Mar; Vol. 49 (3), pp. 960-5. Date of Electronic Publication: 2015 Jun 25. - Publication Year :
- 2016
-
Abstract
- Objectives: The aim of this study was to compare early outcomes and mid-term survival of high-risk patients undergoing minimally invasive aortic valve replacement through right anterior mini-thoracotomy (RT) with sutureless valves versus patients undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis.<br />Methods: From October 2008 to March 2013, 269 patients with severe aortic stenosis underwent either RT with perceval S sutureless valves (n = 178 patients, 66.2%) or TAVI (n = 91, 33.8%: 44 transapical and 47 trans-femoral). Of these, 37 patients undergoing RT with the perceval S valve were matched to a TAVI group by the propensity score.<br />Results: Baseline characteristics were similar in both groups (mean age 79 ± 6 years) and the median logistic EuroSCORE was 14% (range 9-20%). In the matched group, the in-hospital mortality rate was 8.1% (n = 3) in the TAVI group and 0% in the RT group (P = 0.25). The incidence rate of stroke was 5.4% (n = 2) versus 0% in the TAVI and RT groups (P = 0.3). In the TAVI group, 37.8% (n = 14) had mild paravalvular leakage (PVL) and 27% (n = 10) had moderate PVL, whereas 2.7% (n = 1) had mild PVL in the RT group (P < 0.001). One- and 2-year survival rates were 91.6 vs 78.6% and 91.6 vs 66.2% in patients undergoing RT with the perceval S sutureless valve compared with those undergoing TAVI, respectively (P = 0.1).<br />Conclusions: Minimally invasive aortic valve replacement with perceval S sutureless valves through an RT is associated with a trend of better early outcomes and mid-term survival compared with TAVI.<br /> (© The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Subjects :
- Aged
Aged, 80 and over
Female
Heart Valve Prosthesis
Humans
Male
Minimally Invasive Surgical Procedures adverse effects
Minimally Invasive Surgical Procedures instrumentation
Postoperative Complications
Retrospective Studies
Risk Factors
Thoracotomy adverse effects
Thoracotomy instrumentation
Transcatheter Aortic Valve Replacement adverse effects
Aortic Valve surgery
Minimally Invasive Surgical Procedures methods
Thoracotomy methods
Transcatheter Aortic Valve Replacement instrumentation
Transcatheter Aortic Valve Replacement methods
Subjects
Details
- Language :
- English
- ISSN :
- 1873-734X
- Volume :
- 49
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 26113005
- Full Text :
- https://doi.org/10.1093/ejcts/ezv210