Transapical aortic valve implantation in 100 consecutive patients: comparison to propensity-matched conventional aortic valve replacement
Why the study?
The study was conducted to evaluate the outcomes of transapical aortic valve implantation compared with conventional surgery.
Does transapical aortic valve implantation yield comparable survival to conventional aortic valve replacement in high-risk patients with symptomatic aortic valve stenosis?
Population
100 consecutive high-risk patients with symptomatic aortic valve stenosis
Comparison
TA-AVI vs propensity-matched conventional aortic valve replacement
Design
Propensity-matched comparative study
Follow-up
1 year
Authors
Discussion
Loading...
Member takes
Implication
Hypothesis-generating for TA-AVI in high-risk AS; leaves open role versus surgery pending RCTs.
Key Points
- To evaluate the clinical outcomes of transapical aortic valve implantation compared with conventional aortic valve replacement in high-risk surgical patients.
- Assessed 100 consecutive high-risk patients (mean age 82.7 ± 5 years; 77 females) with symptomatic aortic stenosis treated with transapical aortic valve implantation (Edwards SAPIEN xenograft) between February 2006 and January 2008.
- Identified a matched comparison cohort treated with conventional aortic valve replacement using propensity score analysis.
- Transapical valve implantation was successful in 97 patients (3 required early conversion), with 82 early extubations and no new neurological events.
- Thirty-day survival was 90 ± 3% for transapical implantation versus 85 ± 4% for conventional surgery.
- One-year survival reached 73 ± 4% for transapical implantation versus 69 ± 5% for conventional replacement (P = 0.55).
Structured PICO
Does transapical aortic valve implantation yield comparable survival to conventional aortic valve replacement in high-risk patients with symptomatic aortic valve stenosis?
P
Population
High-risk patients with symptomatic aortic valve stenosis (n=100 in the primary intervention cohort), mean age 82.7 +/- 5 years, 77 females.
I
Intervention
Transapical aortic valve implantation (TA-AVI) using the Edwards SAPIEN pericardial xenograft.
C
Comparator
Propensity-matched conventional aortic valve replacement (C-AVR).
O
Outcome
30-day and 1-year survival.hard clinical
Transapical aortic valve implantation is a safe, minimally invasive alternative that provides comparable 1-year survival to conventional surgery in high-risk patients with aortic stenosis.
Cite This Study
Walther et al. (2010) studied this question.