본문 바로가기
KERD
논문KCI 등재

Right anterior mini-thoracotomy aortic valve replacement versus transcatheter aortic valve implantation in octogenarians: a single-center retrospective study

2

조회

0

다운로드

1

인용

0

참고문헌

키워드

주제분류의학일반

초록

Background: The aim of this study was to compare the early outcomes of octogenarians undergoing minimally invasive right anterior mini-thoracotomy aortic valve replacement (RAT-AVR) with those undergoing transcatheter aortic valve implantation (TAVI) for aortic valve disease. Methods: In this single-center retrospective study, data were collected from octogenarians before and after RAT-AVR and TAVI between January 2021 and July 2022. Short-term outcomes, including the length of hospital stay, in-hospital mortality, all-cause mortality, and other major postoperative complications, were compared and analyzed. Results: There were no significant differences in in-hospital mortality, stroke, acute kidney dysfunction requiring renal replacement therapy, length of intensive care unit stay, or length of hospital stay. However, the TAVI group had a higher incidence of permanent pacemaker insertion (10% vs. 0%, p=0.54) and paravalvular leaks (75% vs. 0%, p<0.001). Conclusion: In the present study on octogenarians, both TAVI and RAT-AVR showed comparable short-term results. Although both procedures were considered safe and effective in the selected group, RAT-AVR had a lower incidence of complete atrioventricular block and paravalvular regurgitation.

Abstract

Background: The aim of this study was to compare the early outcomes of octogenarians undergoing minimally invasive right anterior mini-thoracotomy aortic valve replacement (RAT-AVR) with those undergoing transcatheter aortic valve implantation (TAVI) for aortic valve disease. Methods: In this single-center retrospective study, data were collected from octogenarians before and after RAT-AVR and TAVI between January 2021 and July 2022. Short-term outcomes, including the length of hospital stay, in-hospital mortality, all-cause mortality, and other major postoperative complications, were compared and analyzed. Results: There were no significant differences in in-hospital mortality, stroke, acute kidney dysfunction requiring renal replacement therapy, length of intensive care unit stay, or length of hospital stay. However, the TAVI group had a higher incidence of permanent pacemaker insertion (10% vs. 0%, p=0.54) and paravalvular leaks (75% vs. 0%, p<0.001). Conclusion: In the present study on octogenarians, both TAVI and RAT-AVR showed comparable short-term results. Although both procedures were considered safe and effective in the selected group, RAT-AVR had a lower incidence of complete atrioventricular block and paravalvular regurgitation.

참고문헌 (20)

  1. Santarpino G, "Sutureless aortic valve replacement : first-year single-center experience", Ann Thorac Surg, 94, pp.504~509 (2012)
  2. Miceli A, "Minimally invasive aortic valve replacement with a sutureless valve through a right anterior mini-thoracotomy versus transcatheter aortic valve implantation in high-risk patients", Eur J Cardiothorac Surg, 49, pp.960~965 (2016)
  3. Smith CR, "Transcatheter versus surgical aortic-valve replacement in high-risk patients", N Engl J Med, 364, pp.2187~2198 (2011)
  4. Leon MB, "Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery", N Engl J Med, 363, pp.1597~1607 (2010)
  5. Zahn R, "Transcatheter aortic valve implantation : first results from a multi-centre real-world registry", Eur Heart J, 32, pp.198~204 (2011)
  6. Solinas M, "Right anterior mini-thoracotomy and sutureless valves : the perfect marriage", Ann Cardiothorac Surg, 9, pp.305~313 (2020)
  7. Hanedan MO, "Early outcomes of sutureless aortic valves", Korean J Thorac Cardiovasc Surg, 49, pp.165~170 (2016)
  8. King M, "The use of sutureless and rapid-deployment aortic valve prosthesis in patients with bicuspid aortic valve : a focused review", J Card Surg, 37, pp.3355~3362 (2022)
  9. Chiappini B, "Outcome after aortic valve replacement in octogenarians", Ann Thorac Surg, 78, pp.85~89 (2004)
  10. Kodali SK, "Two-year outcomes after transcatheter or surgical aortic-valve replacement", N Engl J Med, 366, pp.1686~1695 (2012)
  11. Takagi H, "A meta-analysis of transcatheter aortic valve implantation versus surgical aortic valve replacement", Ann Thorac Surg, 96, pp.513~519 (2013)
  12. Vasa-Nicotera M, "Impact of paravalvular leakage on outcome in patients after transcatheter aortic valve implantation", JACC Cardiovasc Interv, 5, pp.858~865 (2012)
  13. Doyle MP, "Minimally-invasive versus transcatheter aortic valve implantation : systematic review with meta-analysis of propensity-matched studies", J Thorac Dis, 13, pp.1671~1683 (2021)
  14. Wang N, "Transcatheter aortic valve implantation(TAVI)versus sutureless aortic valve replacement(SUAVR)for aortic stenosis : a systematic review and meta-analysis of matched studies", J Thorac Dis, 8, pp.3283~3293 (2016)
  15. Reardon MJ, "Surgical or transcatheter aortic-valve replacement in intermediate-risk patients", N Engl J Med, 376, pp.1321~1331 (2017)
  16. Leon MB, "Transcatheter or surgical aortic-valve replacement in intermediate-risk patients", N Engl J Med, 374, pp.1609~1620 (2016)
  17. Baraki H, "Pacemaker dependency after isolated aortic valve replacement : do conductance disorders recover over time", Interact Cardiovasc Thorac Surg, 16, pp.476~481 (2013)
  18. Siontis GC, "Transcatheter aortic valve implantation vs. surgical aortic valve replacement for treatment of severe aortic stenosis: a meta-analysis of randomized trials", Eur Heart J, 37, pp.3503~3512 (2016)
  19. Nazif TM, "Predictors and clinical outcomes of permanent pacemaker implantation after transcatheter aortic valve replacement : the PARTNER(Placement of AoRtic TraNscathetER Valves)trial and registry", JACC Cardiovasc Interv, 8, pp.60~69 (2015)
  20. Indraratna P, "Systematic review of the cost-effectiveness of transcatheter aortic valve implantation", J Thorac Cardiovasc Surg, 148, pp.509~514 (2014)

관련 논문AI추천

Aortic valve replacement through right anterior mini-thoracotomy in patients with chronic severe aortic regurgitation: a retrospective single-center studyEun Yeung Jung, Ho-Ki Min, Ji Eun Im, Seok Soo Lee영남대학교 의과대학 · Journal of Yeungnam Medical Science2024 · 제41권 제3호Transcatheter Aortic Valve Replacement versus Sutureless Aortic Valve Replacement: A Single Center Retrospective Cohort Study이삭, 고영국, 곽영란, 심재광, 심지영, 안철민, 이승현, 정영학, 홍그루, 홍명기연세대학교의과대학 · Yonsei Medical Journal2021 · 제62권 제10호Comparison of Early Clinical Outcomes Following Transcatheter Aortic Valve Implantation versus Surgical Aortic Valve Replacement versus Optimal Medical Therapy in Patients Older than 80 Years with Symptomatic Severe Aortic Stenosis이삭, 임의, 고영국, 곽영란, 김병극, 김중선, 신동호, 심재광, 심지영, 장병철, 장양수, 장혁재, 최동훈, 홍명기연세대학교의과대학 · Yonsei Medical Journal2013 · 제54권 제3호Transcatheter Aortic Valve Replacement with Minimal Contrast Dye in Patients with Renal Insufficiency고영국, 김병극, 김중선, 심지영, 안철민, 장양수, 최동훈, 최자연, 홍그루, 홍명기, 홍성진연세대학교의과대학 · Yonsei Medical Journal2021 · 제62권 제11호Recent updates in transcatheter aortic valve implantation김웅, 조정환영남대학교 의과대학 · Journal of Yeungnam Medical Science2018 · 제35권 제1호Multidisciplinary Team Approach for Identifying Potential Candidate for Transcatheter Aortic Valve Implantation이삭, 고영국, 곽영란, 심재광, 장병철, 장양수, 최동훈, 홍그루, 홍명기, 홍성진연세대학교의과대학 · Yonsei Medical Journal2014 · 제55권 제5호

이 간행물의 다른 논문 (9건)