Transcatheter Versus Surgical Valve Replacement: A 24-months Propensity-matched Analysis of the SILCARD Registry

Background: Data concerning the comparison between transcatheter aortic valve implantation and surgical aortic valve replacement in a real-world setting are scarce and in Central and Eastern Europe no such data exist. In this study, we aimed at analyzing retrospectively the characteristics and outco...

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Main Authors: Krzysztof Wilczek, Michal Hawranek, Wojciech Wojakowski, Piotr Chodór, Michal Zembala, Pawel Buszman, Andrzej Bochenek, Marek Deja, Maciej Dyrbus, Daniel Ciesla, Zbigniew Kalarus, Mariusz Gasior, Marian Zembala
Format: Article
Language:English
Published: KARE Publishing 2022-03-01
Series:Anatolian Journal of Cardiology
Subjects:
Online Access:https://jag.journalagent.com/z4/download_fulltext.asp?pdir=anatoljcardiol&un=AJC-83009
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author Krzysztof Wilczek
Michal Hawranek
Wojciech Wojakowski
Piotr Chodór
Michal Zembala
Pawel Buszman
Andrzej Bochenek
Marek Deja
Maciej Dyrbus
Daniel Ciesla
Zbigniew Kalarus
Mariusz Gasior
Marian Zembala
author_facet Krzysztof Wilczek
Michal Hawranek
Wojciech Wojakowski
Piotr Chodór
Michal Zembala
Pawel Buszman
Andrzej Bochenek
Marek Deja
Maciej Dyrbus
Daniel Ciesla
Zbigniew Kalarus
Mariusz Gasior
Marian Zembala
author_sort Krzysztof Wilczek
collection DOAJ
description Background: Data concerning the comparison between transcatheter aortic valve implantation and surgical aortic valve replacement in a real-world setting are scarce and in Central and Eastern Europe no such data exist. In this study, we aimed at analyzing retrospectively the characteristics and outcome of patients with aortic stenosis treated either with surgical aortic valve replacement or transcatheter aortic valve implantation between 2006 and 2016 in the Silesian Province, Poland in a representative real-world cohort. Methods: In the Silesian Cardiovascular Database we retrospectively identified 5186 patients who received either transcatheter aortic valve implantation or surgical aortic valve replacement in 1 of 3 tertiary cardiovascular centers. Baseline characteristics, including relevant clinical history, and outcomes were compared before and after propensity-score matching of both groups, with 348 pairs of patients constituting the propensity-matched study cohort. The primary end-point was 24-month all-cause mortality. Results: Preoperative characteristics of propensity-matched groups were similar. There was no difference between transcatheter aortic valve implantation and surgical aortic valve replacement groups with respect to the death rate at 2 years (19.9% vs. 15.6%; P = .479). In the transcatheter aortic valve implantation group, cardiac resynchronization therapy devices were more frequently implanted after the procedure (3.7% vs. 0.0, P <.001). The groups had similar rates of myocardial infarction, stroke, and re-hospitalization. Hospital stay in the matched groups was shorter after transcatheter aortic valve implantation: 14.1 versus 15.7 days (P <.001). Conclusions: At 24 months, transcatheter aortic valve implantation patients had similar outcomes as surgical aortic valve replacement except for a higher rate of cardiac resynchronization therapy device implantation and shorter hospital stay.
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spelling doaj.art-529ee8b3b09a4f108d5c14bf7ae735992023-11-07T17:36:37ZengKARE PublishingAnatolian Journal of Cardiology2149-22712022-03-0126317217910.5152/AnatolJCardiol.2021.83009AJC-83009Transcatheter Versus Surgical Valve Replacement: A 24-months Propensity-matched Analysis of the SILCARD RegistryKrzysztof Wilczek0Michal Hawranek1Wojciech Wojakowski2Piotr Chodór3Michal Zembala4Pawel Buszman5Andrzej Bochenek6Marek Deja7Maciej Dyrbus8Daniel Ciesla9Zbigniew Kalarus10Mariusz Gasior11Marian Zembala12Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Silesian Centre for Heart Disease in Zabrze, PolandDepartment of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Silesian Centre for Heart Disease in Zabrze, PolandDepartment Of Cardiology And Structural Heart Diseases, 3rd Division Of Cardiology, Medical University Of Silesia, Katowice, PolandDepartment Of Cardiology, Congenital Heart Diseases And Electrotherapy, Silesian Centre For Heart Disease In Zabrze, Medical University Of Silesia, Katowice, PolandDepartment Of Cardiac, Vascular And Endovascular Surgery And Transplantology, Medical University Of Silesia, Katowice, Poland, Silesian Centre For Heart Disease In Zabrze, PolandAmerican Heart Of Poland, Katowice, PolandAmerican Heart Of Poland, Katowice, PolandDepartment Of Cardiac Surgery, Medical University Of Silesia, Katowice, PolandStudent Scientific Society, 3rd Department Of Cardiology, School Of Medical Sciences In Zabrze, Medical University Of Silesia, Katowice, Poland.Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Silesian Centre for Heart Disease in Zabrze, PolandDepartment Of Cardiology, Congenital Heart Diseases And Electrotherapy, Silesian Centre For Heart Disease In Zabrze, Medical University Of Silesia, Katowice, PolandDepartment of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Silesian Centre for Heart Disease in Zabrze, PolandDepartment Of Cardiac, Vascular And Endovascular Surgery And Transplantology, Medical University Of Silesia, Katowice, Poland, Silesian Centre For Heart Disease In Zabrze, PolandBackground: Data concerning the comparison between transcatheter aortic valve implantation and surgical aortic valve replacement in a real-world setting are scarce and in Central and Eastern Europe no such data exist. In this study, we aimed at analyzing retrospectively the characteristics and outcome of patients with aortic stenosis treated either with surgical aortic valve replacement or transcatheter aortic valve implantation between 2006 and 2016 in the Silesian Province, Poland in a representative real-world cohort. Methods: In the Silesian Cardiovascular Database we retrospectively identified 5186 patients who received either transcatheter aortic valve implantation or surgical aortic valve replacement in 1 of 3 tertiary cardiovascular centers. Baseline characteristics, including relevant clinical history, and outcomes were compared before and after propensity-score matching of both groups, with 348 pairs of patients constituting the propensity-matched study cohort. The primary end-point was 24-month all-cause mortality. Results: Preoperative characteristics of propensity-matched groups were similar. There was no difference between transcatheter aortic valve implantation and surgical aortic valve replacement groups with respect to the death rate at 2 years (19.9% vs. 15.6%; P = .479). In the transcatheter aortic valve implantation group, cardiac resynchronization therapy devices were more frequently implanted after the procedure (3.7% vs. 0.0, P <.001). The groups had similar rates of myocardial infarction, stroke, and re-hospitalization. Hospital stay in the matched groups was shorter after transcatheter aortic valve implantation: 14.1 versus 15.7 days (P <.001). Conclusions: At 24 months, transcatheter aortic valve implantation patients had similar outcomes as surgical aortic valve replacement except for a higher rate of cardiac resynchronization therapy device implantation and shorter hospital stay.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=anatoljcardiol&un=AJC-83009aortic stenosistranscatheter aortic valve implantationtavisurgical aortic valve replacementsavr
spellingShingle Krzysztof Wilczek
Michal Hawranek
Wojciech Wojakowski
Piotr Chodór
Michal Zembala
Pawel Buszman
Andrzej Bochenek
Marek Deja
Maciej Dyrbus
Daniel Ciesla
Zbigniew Kalarus
Mariusz Gasior
Marian Zembala
Transcatheter Versus Surgical Valve Replacement: A 24-months Propensity-matched Analysis of the SILCARD Registry
Anatolian Journal of Cardiology
aortic stenosis
transcatheter aortic valve implantation
tavi
surgical aortic valve replacement
savr
title Transcatheter Versus Surgical Valve Replacement: A 24-months Propensity-matched Analysis of the SILCARD Registry
title_full Transcatheter Versus Surgical Valve Replacement: A 24-months Propensity-matched Analysis of the SILCARD Registry
title_fullStr Transcatheter Versus Surgical Valve Replacement: A 24-months Propensity-matched Analysis of the SILCARD Registry
title_full_unstemmed Transcatheter Versus Surgical Valve Replacement: A 24-months Propensity-matched Analysis of the SILCARD Registry
title_short Transcatheter Versus Surgical Valve Replacement: A 24-months Propensity-matched Analysis of the SILCARD Registry
title_sort transcatheter versus surgical valve replacement a 24 months propensity matched analysis of the silcard registry
topic aortic stenosis
transcatheter aortic valve implantation
tavi
surgical aortic valve replacement
savr
url https://jag.journalagent.com/z4/download_fulltext.asp?pdir=anatoljcardiol&un=AJC-83009
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