September 1, 2014EuroIntervention
Transcatheter aortic valve implantation (TAVI) by centres with and without an on-site cardiac surgery programme: preliminary experience from the German TAVI registry
Key result
TAVI performed at hospitals without an on-site cardiac surgery department resulted in a 30-day mortality of 6.2%, compared to 8.3% at hospitals with on-site cardiac surgery.
Why the study?
Does performing TAVI at hospitals without on-site cardiac surgery affect procedural success and 30-day mortality compared to hospitals with on-site cardiac surgery?
Population
1,432 patients undergoing transcatheter aortic valve implantation enrolled in the German TAVI registry at 27…
Comparison
Transcatheter aortic valve implantation… vs Transcatheter aortic valve implantation…
Design
Cohort
Follow-up
30-day
Authors
Discussion
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Member takes
Implication
Supports TAVI without on-site surgery in selected centers; leaves open confirmation in randomized trials.
Study Design
Type
Observational (n=1,432)
Multicenter
Yes
Structured PICO
Does performing TAVI at hospitals without on-site cardiac surgery affect procedural success and 30-day mortality compared to hospitals with on-site cardiac surgery?
P
Population
1,432 patients undergoing transcatheter aortic valve implantation (TAVI) enrolled in the German TAVI registry at 27 hospitals. Mean age ~82 years, average logistic EuroSCORE 21%.
I
Intervention
Transcatheter aortic valve implantation (TAVI) performed at hospitals without an on-site cardiac surgery department (n=178, 8 centres)
C
Comparator
Transcatheter aortic valve implantation (TAVI) performed at hospitals with an on-site cardiac surgery department (n=1,254, 19 centres)
O
Outcome
Procedural success rate and 30-day mortalityhard clinical
Main Result
Absolute Event Rate: 6.2% vs 8.3%
TAVI performed at centers without on-site cardiac surgery appears feasible with similar 30-day mortality and complication rates compared to centers with on-site surgery, though procedural success was slightly lower.
Limitations
- Modest number of patients in the non-CS group requiring confirmation in future large studies
- Modest number of patients in the non-cardiac surgery group
- Preliminary data requiring confirmation in future studies involving a large number of patients
Cite This Study
Eggebrecht et al. (2014) conducted an observational in Aortic stenosis (n=1,432). TAVI at hospitals without on-site cardiac surgery vs. TAVI at hospitals with on-site cardiac surgery was evaluated on 30-day mortality. TAVI performed at hospitals without an on-site cardiac surgery department resulted in a 30-day mortality of 6.2%, compared to 8.3% at hospitals with on-site cardiac surgery.