Ten-year outcomes after transcatheter or surgical aortic valve replacement in low-risk patients: The OBSERVANT study
Background: The evidence of the long-term advantages of transcatheter aortic valve replacement (TAVR) over surgical aortic valve replacement (SAVR) for aortic stenosis (AS) remains scarce. Methods: Patients with EuroSCORE II < 4 % who underwent TAVR or SAVR for AS from the prospective observation...
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Elsevier
2024-12-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906724002112 |
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| author | Fausto Biancari Paola D’Errigo Marco Barbanti Gabriella Badoni Corrado Tamburino Gianluca Polvani Giuliano Costa Giovanni Baglio Stefano Rosato |
| author_facet | Fausto Biancari Paola D’Errigo Marco Barbanti Gabriella Badoni Corrado Tamburino Gianluca Polvani Giuliano Costa Giovanni Baglio Stefano Rosato |
| author_sort | Fausto Biancari |
| collection | DOAJ |
| description | Background: The evidence of the long-term advantages of transcatheter aortic valve replacement (TAVR) over surgical aortic valve replacement (SAVR) for aortic stenosis (AS) remains scarce. Methods: Patients with EuroSCORE II < 4 % who underwent TAVR or SAVR for AS from the prospective observational OBSERVANT study were included in this analysis. Ten-year survival was the primary outcome of this analysis. Secondary outcome was repeat procedure on the aortic valve prosthesis. Results: Propensity score matching resulted in 355 matched pairs of patients who underwent TAVR or SAVR. The mean age of SAVR patients was 80.0 ± 5.1 years and that of TAVR patients 80.1 ± 6.4 years (p = 0.81) and the mean EuroSCORE II was 2.5 ± 0.8 % and 2.6 ± 0.8 % (p = 0.60), respectively. Thirty-day mortality was 2.8 % after SAVR and 2.5 % after TAVR (p = 0.82). At 10-year, survival was 37.0 % (95 %CI 32.2–42.5 %) after SAVR and 18.2 % (95 %CI 14.5–22.8 %) after TAVR (Log-rank test, p < 0.001; HR 1.70, 95 %CI 1.42–2.03). Difference in terms of survival between the propensity matched cohorts became significant 3 years after the procedures. Ten-year cumulative incidences of repeat aortic valve procedure were 2.6 % (95 %CI 1.4–5.0 %) after SAVR and 1.1 % (95 %CI 0.4–3.0 %) after TAVR (p = 0.153; SHR 0.43, 95 %CI 0.13–1.41). Conclusions: The results of this prospective observational, non-randomized study showed that 10-year survival of low-risk patients who underwent TAVR with early generation prosthesis devices was lower than SAVR. |
| format | Article |
| id | doaj-art-d2c4a7ffae2c4386be4e87572acdfb8c |
| institution | OA Journals |
| issn | 2352-9067 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
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| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj-art-d2c4a7ffae2c4386be4e87572acdfb8c2025-08-20T02:07:01ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672024-12-015510154510.1016/j.ijcha.2024.101545Ten-year outcomes after transcatheter or surgical aortic valve replacement in low-risk patients: The OBSERVANT studyFausto Biancari0Paola D’Errigo1Marco Barbanti2Gabriella Badoni3Corrado Tamburino4Gianluca Polvani5Giuliano Costa6Giovanni Baglio7Stefano Rosato8Department of Cardiovascular Surgery, Centro Cardiologico Monzino IRCCS, Milan, Italy; Corresponding author at: Department of Cardiovascular Surgery, Centro Cardiologico Monzino IRCCS, Milan 20138, Italy.National Center for Global Health, Istituto Superiore di Sanitá, Rome, ItalyUniversità degli Studi di Enna “Kore”, Enna, Italy; Division of Cardiology, Ospedale Umberto I, ASP 4 di Enna, Enna, ItalyNational Center for Global Health, Istituto Superiore di Sanitá, Rome, ItalyDivision of Cardiology, Azienda Ospedaliera Universitaria Policlinico “G. Rodolico-San Marco”, Catania, ItalyDepartment of Cardiovascular Surgery, Centro Cardiologico Monzino IRCCS, Milan, Italy; Department of Biomedical, Surgical and Dental Sciences, University of Milan, ItalyDivision of Cardiology, Azienda Ospedaliera Universitaria Policlinico “G. Rodolico-San Marco”, Catania, ItalyItalian National Agency for Regional Healthcare Services, Rome, ItalyNational Center for Global Health, Istituto Superiore di Sanitá, Rome, ItalyBackground: The evidence of the long-term advantages of transcatheter aortic valve replacement (TAVR) over surgical aortic valve replacement (SAVR) for aortic stenosis (AS) remains scarce. Methods: Patients with EuroSCORE II < 4 % who underwent TAVR or SAVR for AS from the prospective observational OBSERVANT study were included in this analysis. Ten-year survival was the primary outcome of this analysis. Secondary outcome was repeat procedure on the aortic valve prosthesis. Results: Propensity score matching resulted in 355 matched pairs of patients who underwent TAVR or SAVR. The mean age of SAVR patients was 80.0 ± 5.1 years and that of TAVR patients 80.1 ± 6.4 years (p = 0.81) and the mean EuroSCORE II was 2.5 ± 0.8 % and 2.6 ± 0.8 % (p = 0.60), respectively. Thirty-day mortality was 2.8 % after SAVR and 2.5 % after TAVR (p = 0.82). At 10-year, survival was 37.0 % (95 %CI 32.2–42.5 %) after SAVR and 18.2 % (95 %CI 14.5–22.8 %) after TAVR (Log-rank test, p < 0.001; HR 1.70, 95 %CI 1.42–2.03). Difference in terms of survival between the propensity matched cohorts became significant 3 years after the procedures. Ten-year cumulative incidences of repeat aortic valve procedure were 2.6 % (95 %CI 1.4–5.0 %) after SAVR and 1.1 % (95 %CI 0.4–3.0 %) after TAVR (p = 0.153; SHR 0.43, 95 %CI 0.13–1.41). Conclusions: The results of this prospective observational, non-randomized study showed that 10-year survival of low-risk patients who underwent TAVR with early generation prosthesis devices was lower than SAVR.http://www.sciencedirect.com/science/article/pii/S2352906724002112Aortic valve stenosisTranscatheter aortic valve replacementTAVRSAVRlow risk |
| spellingShingle | Fausto Biancari Paola D’Errigo Marco Barbanti Gabriella Badoni Corrado Tamburino Gianluca Polvani Giuliano Costa Giovanni Baglio Stefano Rosato Ten-year outcomes after transcatheter or surgical aortic valve replacement in low-risk patients: The OBSERVANT study International Journal of Cardiology: Heart & Vasculature Aortic valve stenosis Transcatheter aortic valve replacement TAVR SAVR low risk |
| title | Ten-year outcomes after transcatheter or surgical aortic valve replacement in low-risk patients: The OBSERVANT study |
| title_full | Ten-year outcomes after transcatheter or surgical aortic valve replacement in low-risk patients: The OBSERVANT study |
| title_fullStr | Ten-year outcomes after transcatheter or surgical aortic valve replacement in low-risk patients: The OBSERVANT study |
| title_full_unstemmed | Ten-year outcomes after transcatheter or surgical aortic valve replacement in low-risk patients: The OBSERVANT study |
| title_short | Ten-year outcomes after transcatheter or surgical aortic valve replacement in low-risk patients: The OBSERVANT study |
| title_sort | ten year outcomes after transcatheter or surgical aortic valve replacement in low risk patients the observant study |
| topic | Aortic valve stenosis Transcatheter aortic valve replacement TAVR SAVR low risk |
| url | http://www.sciencedirect.com/science/article/pii/S2352906724002112 |
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