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SHR Neuro Krebs Kardio Lipid

Egger, F; Zweiker, D; Freynhofer, MK; Löffler, V; Rohla, M; Geppert, A; Farhan, S; Vogel, B; Falkensammer, J; Kastner, J; Pichler, P; Vock, P; Lamm, G; Luha, O; Schmidt, A; Scherr, D; Hammerer, M; Hoppe, UC; Maurer, E; Grund, M; Lambert, T; Tkalec, W; Sturmberger, T; Zeindlhofer, E; Grabenwöger, M; Huber, K; Austrian TAVI Group.
Impact of On-Site Cardiac Surgery on Clinical Outcomes After Transfemoral Transcatheter Aortic Valve Replacement.
JACC Cardiovasc Interv. 2018; 11(21):2160-2167
Web of Science PubMed FullText FullText_MUG

 

Autor/innen der Med Uni Graz:
Scherr Daniel
Schmidt Albrecht
Zweiker David
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Abstract:
This study sought to investigate the outcome of high-risk and inoperable patients with severe symptomatic aortic stenosis undergoing transfemoral transcatheter aortic valve replacement (TAVR) in hospitals with (iOSCS) versus without institutional on-site cardiac surgery (no-iOSCS). Current guidelines recommend the use of TAVR only in institutions with a department for cardiac surgery on site. In this analysis of the prospective multicenter Austrian TAVI registry, 1,822 consecutive high-risk patients with severe symptomatic aortic stenosis undergoing transfemoral TAVR were evaluated. A total of 290 (15.9%) underwent TAVR at no-iOSCS centers (no-iOSCS group), whereas the remaining 1,532 patients (84.1%) were treated in iOSCS centers (iOSCS group). Patients of the no-iOSCS group had a higher perioperative risk defined by the logistic EuroSCORE (20.9% vs. 14.2%; p < 0.001) compared with patients treated in hospitals with iOSCS. Procedural survival was 96.9% in no-iOSCS centers and 98.6% in iOSCS centers (p = 0.034), whereas 30-day survival was 93.1% versus 96.0% (p = 0.039) and 1-year survival was 80.9% versus 86.1% (p = 0.017), respectively. After propensity score matching for confounders procedural survival was 96.9% versus 98.6% (p = 0.162), 93.1% versus 93.8% (p = 0.719) at 30 days, and 80.9% versus 83.4% (p = 0.402) at 1 year. Patients undergoing transfemoral TAVR in hospitals without iOSCS had a significantly higher baseline risk profile. After propensity score matching short- and long-term mortality was similar between centers with and without iOSCS. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Find related publications in this database (Keywords)
aortic stenosis
on-site cardiac surgery
TAVR
transfemoral
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