Why the study?
The choice of aortic valve stenosis correction method depends on clinical and technical parameters, prompting a comparison of early postoperative outcomes between TAVI and surgical aortic valve replacement with a biological prosthesis.
Does transcatheter aortic valve implantation improve early postoperative outcomes compared to surgical aortic valve replacement with a biological prosthesis in adult patients with aortic valve stenosis?
Does transcatheter aortic valve implantation improve early postoperative outcomes compared to surgical aortic valve replacement with a biological prosthesis in adult patients with aortic valve stenosis?
TAVI is associated with fewer early postoperative complications and shorter hospital stays compared to SAVR with a biological prosthesis, even in patients with higher baseline surgical risk.
TAVI-associated early benefits in observational data warrant caution against practice change; leaves open need for randomized confirmation.
OBJECTIVE: . Aim: The choice of aortic valve stenosis correction method is determined by a number of clinical and technical parameters. The task was to compare early postoperative outcomes in patients after correction of aortic valve stenosis using TAVI and surgical aortic valve replacement with a biological prosthesis. PATIENTS AND METHODS: Materials and Methods: This retrospective study analyzed the medical records of adult patients (18 years of age and older) who had transcatheter aortic valve implantation or surgical aortic valve replacement with a biological prosthesis at the State Institution "Heart Institute of the Ministry of Health" in the period from 2018 to 2022. RESULTS: Results: In 47 (47.5%) cases, TAVI was performed and in 52 (52.5%) cases, SAVR with a biological prosthesis was performed. Patients who underwent TAVI were significantly older (p=0.002) and had a higher EuroSCORE II operative risk score (p<0.001). In patients with TAVI, larger diameter aortic valve prostheses were significantly more often used compared with the SAVR group with biological prosthesis (27.5±2.74 vs. 22.5±1.84, p<0.001). The early postoperative period in patients with TAVI was characterized by an 11.4% (p=0.046) and 15.4% (p=0.006). The length of stay in the ICU (p=0.024), as well as the duration of hospitalization in general (p=0.005), was also significantly lower in patients with TAVI compared with patients with biological prosthesis SAVR. CONCLUSION: Conclusions: Despite the higher surgical risk of surgery according to EuroSCORE II, TAVI was characterized by a lower incidence of postoperative complications, with shorter duration of stay in ICU and hospitalization in general in comparison with patients undergoing SAVR with a biological prosthesis.
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Todurov et al. (2024) studied this question.
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