Transcatheter aortic valve implantation vs surgical aortic valve replacement in high-risk patients with aortic stenosis
Objective The aim was to demonstrate whether transcatheter aortic valve implantation (TAVI) improves mortality and morbidity compared with standard surgical aortic valve replacement (SAVR) in high-risk patients requiring intervention for aortic valve stenosis (AS). Many patients with severe AS and c...
| Main Author: | |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
General Organization of Teaching Hospitals and Institutes
2020-01-01
|
| Series: | Journal of Medicine in Scientific Research |
| Subjects: | |
| Online Access: | http://www.jmsr.eg.net/article.asp?issn=2537-091X;year=2020;volume=3;issue=3;spage=227;epage=232;aulast=Sarawy |
| _version_ | 1827298013428580352 |
|---|---|
| author | Emad Sarawy |
| author_facet | Emad Sarawy |
| author_sort | Emad Sarawy |
| collection | DOAJ |
| description | Objective
The aim was to demonstrate whether transcatheter aortic valve implantation (TAVI) improves mortality and morbidity compared with standard surgical aortic valve replacement (SAVR) in high-risk patients requiring intervention for aortic valve stenosis (AS). Many patients with severe AS and coexisting morbidity are not candidates for surgical replacement of the aortic valve (AV). TAVI has been suggested as an alternative less invasive treatment for high-risk patients with AS.
Patients and methods
A total of 50 patients with high-risk severe AS for AV intervention were classified into: group A, the TAVI group, including 25 patients who underwent AV replacement via the transcatheter femoral approach and group B, the SAVR group, including 25 patients who underwent standard SAVR via median sternotomy.
Results
Intraoperatively, procedure duration was 101.8 ± 10.6 and 191.2 ± 7.5 min in group A and B, respectively (P < 0.001). Major vascular complications occurred in 20% of patients in group A vs 0% of patients in group B (P = 0.018). Postoperative follow-up, mean ICU stay was 3 ± 2.4 and 4.8 ± 3.5 days in group A and group B, respectively (P = 0.035). In group A, 32% of patients needed permanent pacemakers. In group A, 12% of patients developed stroke or transient ischemic attacks. Paravalvular aortic regurgitation occurred in 36.3 and 4.5% of patients in group A and group B, respectively (P = 0.009).
Conclusions
In high-risk patients with severe AS, transcatheter and surgical procedures for aortic-valve replacement were comparable for survival at 3 months, although there were important differences in periprocedural outcomes. |
| first_indexed | 2024-04-24T15:07:00Z |
| format | Article |
| id | doaj.art-06b06a879036456abdc321b4fb400e81 |
| institution | Directory Open Access Journal |
| issn | 2537-091X 2537-0928 |
| language | English |
| last_indexed | 2024-04-24T15:07:00Z |
| publishDate | 2020-01-01 |
| publisher | General Organization of Teaching Hospitals and Institutes |
| record_format | Article |
| series | Journal of Medicine in Scientific Research |
| spelling | doaj.art-06b06a879036456abdc321b4fb400e812024-04-02T12:39:15ZengGeneral Organization of Teaching Hospitals and InstitutesJournal of Medicine in Scientific Research2537-091X2537-09282020-01-013322723210.4103/JMISR.JMISR_16_20Transcatheter aortic valve implantation vs surgical aortic valve replacement in high-risk patients with aortic stenosisEmad SarawyObjective The aim was to demonstrate whether transcatheter aortic valve implantation (TAVI) improves mortality and morbidity compared with standard surgical aortic valve replacement (SAVR) in high-risk patients requiring intervention for aortic valve stenosis (AS). Many patients with severe AS and coexisting morbidity are not candidates for surgical replacement of the aortic valve (AV). TAVI has been suggested as an alternative less invasive treatment for high-risk patients with AS. Patients and methods A total of 50 patients with high-risk severe AS for AV intervention were classified into: group A, the TAVI group, including 25 patients who underwent AV replacement via the transcatheter femoral approach and group B, the SAVR group, including 25 patients who underwent standard SAVR via median sternotomy. Results Intraoperatively, procedure duration was 101.8 ± 10.6 and 191.2 ± 7.5 min in group A and B, respectively (P < 0.001). Major vascular complications occurred in 20% of patients in group A vs 0% of patients in group B (P = 0.018). Postoperative follow-up, mean ICU stay was 3 ± 2.4 and 4.8 ± 3.5 days in group A and group B, respectively (P = 0.035). In group A, 32% of patients needed permanent pacemakers. In group A, 12% of patients developed stroke or transient ischemic attacks. Paravalvular aortic regurgitation occurred in 36.3 and 4.5% of patients in group A and group B, respectively (P = 0.009). Conclusions In high-risk patients with severe AS, transcatheter and surgical procedures for aortic-valve replacement were comparable for survival at 3 months, although there were important differences in periprocedural outcomes.http://www.jmsr.eg.net/article.asp?issn=2537-091X;year=2020;volume=3;issue=3;spage=227;epage=232;aulast=Sarawyaortic valve stenosissternotomytranscatheter aortic valve implantation |
| spellingShingle | Emad Sarawy Transcatheter aortic valve implantation vs surgical aortic valve replacement in high-risk patients with aortic stenosis Journal of Medicine in Scientific Research aortic valve stenosis sternotomy transcatheter aortic valve implantation |
| title | Transcatheter aortic valve implantation vs surgical aortic valve replacement in high-risk patients with aortic stenosis |
| title_full | Transcatheter aortic valve implantation vs surgical aortic valve replacement in high-risk patients with aortic stenosis |
| title_fullStr | Transcatheter aortic valve implantation vs surgical aortic valve replacement in high-risk patients with aortic stenosis |
| title_full_unstemmed | Transcatheter aortic valve implantation vs surgical aortic valve replacement in high-risk patients with aortic stenosis |
| title_short | Transcatheter aortic valve implantation vs surgical aortic valve replacement in high-risk patients with aortic stenosis |
| title_sort | transcatheter aortic valve implantation vs surgical aortic valve replacement in high risk patients with aortic stenosis |
| topic | aortic valve stenosis sternotomy transcatheter aortic valve implantation |
| url | http://www.jmsr.eg.net/article.asp?issn=2537-091X;year=2020;volume=3;issue=3;spage=227;epage=232;aulast=Sarawy |
| work_keys_str_mv | AT emadsarawy transcatheteraorticvalveimplantationvssurgicalaorticvalvereplacementinhighriskpatientswithaorticstenosis |