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Lower mortality in an all-comers aortic stenosis population treated with TAVI in comparison to SAVR

  • Helge MöllmannEmail author
  • Oliver Husser
  • Johannes Blumenstein
  • Christoph Liebetrau
  • Oliver Dörr
  • Won-Keun Kim
  • Holger Nef
  • Christian Tesche
  • Christian W. Hamm
  • Albrecht Elsässer
  • Stephan Achenbach
  • Luise Gaede
Original Paper

Abstract

Background

Within the last years TAVI—especially transfemoral/transvascular TAVI—has proven to be a valuable therapeutic option for most patients suffering from AS. Here, we present the outcome of a complete dataset of all patients undergoing aortic valve replacement in Germany in 2018.

Methods

The data of all aortic valve procedures performed in Germany in 2018 derive from the mandatory nationwide quality control program. Patients were stratified with a new version of the German Aortic valve score (AKL Score) divided in different risk stratification depending on the treatment with either a catheter based (TV-TAVI) or surgical (iSAVR) approach. In-hospital outcomes have been compared between the two approaches.

Results

19,317 transvascular (TV)–TAVI procedures were carried out. In contrast to this steady growth, the number of iSAVR andtransapical (TA) -TAVI procedures declined. In-hospital mortality after TV-TAVI (2.5%) was lower when compared to iSAVR (3.1%) as well as TA-TAVI (5.7%) in-hospital mortality after TV-TAVI was significantly lowest (Fig. 2) with an in-hospital mortality rate of 2.5%. TV-TAVI was the only approach with an observed vs. expected mortality ratio < 1 according to the used risk prediction model.

Conclusion

TV-TAVI is more often performed and shows lower in-hospital mortality than iSAVR. TV-TAVI has replaced iSAVR as the gold-standard concerning in-hospital outcome in aortic stenosis management.

Keywords

TAVR TAVI Mortality SAVR Real-world Registry 

Notes

Compliance with ethical standards

Conflict of interest

HM received speaker honoraria/proctor fees from Abbott, Biotronik, Boston Scientific, Edwards; OH and JB received proctor fees from Boston Scientific. LG receives speaker honoraria from Edwards and Abbott.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Helge Möllmann
    • 1
    Email author
  • Oliver Husser
    • 1
  • Johannes Blumenstein
    • 1
  • Christoph Liebetrau
    • 2
  • Oliver Dörr
    • 3
  • Won-Keun Kim
    • 2
  • Holger Nef
    • 3
  • Christian Tesche
    • 1
  • Christian W. Hamm
    • 2
    • 3
  • Albrecht Elsässer
    • 4
  • Stephan Achenbach
    • 5
  • Luise Gaede
    • 5
  1. 1.Department of Internal MedicineSt. Johannes-Hospital DortmundDortmundGermany
  2. 2.Department of CardiologyKerckhoff Heart and Thorax CenterBad NauheimGermany
  3. 3.Department of Cardiology and Angiology, Medical Clinic IUniversity of GiessenGiessenGermany
  4. 4.Department of CardiologyKlinikum OldenburgOldenburgGermany
  5. 5.Medizinische Klinik 2Friedrich Alexander Universität Erlangen-NürnbergErlangenGermany

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