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Article Type

Original Study

Abstract

Objective The aim was to demonstrate whether transcatheter aortic valve implantation (TAVI) improves mortality and morbidity compared with standard surgical aortic valve replacement (SAVR) in high-risk patients requiring intervention for aortic valve stenosis (AS). Many patients with severe AS and coexisting morbidity are not candidates for surgical replacement of the aortic valve (AV). TAVI has been suggested as an alternative less invasive treatment for high-risk patients with AS. Patients and methods A total of 50 patients with high-risk severe AS for AV intervention were classified into: group A, the TAVI group, including 25 patients who underwent AV replacement via the transcatheter femoral approach and group B, the SAVR group, including 25 patients who underwent standard SAVR via median sternotomy. Results Intraoperatively, procedure duration was 101.8 ± 10.6 and 191.2 ± 7.5 min in group A and B, respectively (P < 0.001). Major vascular complications occurred in 20% of patients in group A vs 0% of patients in group B (P = 0.018). Postoperative follow-up, mean ICU stay was 3 ± 2.4 and 4.8 ± 3.5 days in group A and group B, respectively (P = 0.035). In group A, 32% of patients needed permanent pacemakers. In group A, 12% of patients developed stroke or transient ischemic attacks. Paravalvular aortic regurgitation occurred in 36.3 and 4.5% of patients in group A and group B, respectively (P = 0.009). Conclusions In high-risk patients with severe AS, transcatheter and surgical procedures for aortic-valve replacement were comparable for survival at 3 months, although there were important differences in periprocedural outcomes.

Keywords

Aortic valve stenosis, sternotomy, transcatheter aortic valve implantation

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