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
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)
- Santarpino G, "Sutureless aortic valve replacement : first-year single-center experience", Ann Thorac Surg, 94, pp.504~509 (2012)
- 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)
- Smith CR, "Transcatheter versus surgical aortic-valve replacement in high-risk patients", N Engl J Med, 364, pp.2187~2198 (2011)
- Leon MB, "Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery", N Engl J Med, 363, pp.1597~1607 (2010)
- Zahn R, "Transcatheter aortic valve implantation : first results from a multi-centre real-world registry", Eur Heart J, 32, pp.198~204 (2011)
- Solinas M, "Right anterior mini-thoracotomy and sutureless valves : the perfect marriage", Ann Cardiothorac Surg, 9, pp.305~313 (2020)
- Hanedan MO, "Early outcomes of sutureless aortic valves", Korean J Thorac Cardiovasc Surg, 49, pp.165~170 (2016)
- 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)
- Chiappini B, "Outcome after aortic valve replacement in octogenarians", Ann Thorac Surg, 78, pp.85~89 (2004)
- Kodali SK, "Two-year outcomes after transcatheter or surgical aortic-valve replacement", N Engl J Med, 366, pp.1686~1695 (2012)
- Takagi H, "A meta-analysis of transcatheter aortic valve implantation versus surgical aortic valve replacement", Ann Thorac Surg, 96, pp.513~519 (2013)
- Vasa-Nicotera M, "Impact of paravalvular leakage on outcome in patients after transcatheter aortic valve implantation", JACC Cardiovasc Interv, 5, pp.858~865 (2012)
- 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)
- 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)
- Reardon MJ, "Surgical or transcatheter aortic-valve replacement in intermediate-risk patients", N Engl J Med, 376, pp.1321~1331 (2017)
- Leon MB, "Transcatheter or surgical aortic-valve replacement in intermediate-risk patients", N Engl J Med, 374, pp.1609~1620 (2016)
- Baraki H, "Pacemaker dependency after isolated aortic valve replacement : do conductance disorders recover over time", Interact Cardiovasc Thorac Surg, 16, pp.476~481 (2013)
- 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)
- 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)
- Indraratna P, "Systematic review of the cost-effectiveness of transcatheter aortic valve implantation", J Thorac Cardiovasc Surg, 148, pp.509~514 (2014)
