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TAVI vs Aortic Valve Replacement Surgery: Comparison of In-Hospital Outcomes in Patients with Severe Aortic Stenosis
Session:
Sessão de Posters 47 - TAVI
Speaker:
Margarida Temtem
Congress:
CPC 2024
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Cartazes
FP Number:
---
Authors:
Margarida Temtem; Joana Correia; Carlos Peña Gil; Marta Alonso Vázquez; Manuela Sestayo Fernández; Bibiana Villamayor Blanco; Carmen Neiro Rey; Belén Adrio Nazar; Diego López Otero; Ramiro Trillo Nouche; José Ramón González Juanatey; Violeta González-Salvado
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Introduction</strong>: Valve replacement procedures in cases of aortic stenosis (AS), whether surgical or percutaneous, entail diverse risks dependent on both patient profile and the type of intervention, which can influence in-hospital prognosis. </span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">The aim of this study was to analyze and compare the in-hospital outcomes of patients undergoing surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI).</span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Methods</strong>: Observational study at a single center involving consecutive patients with severe aortic stenosis (AS) undergoing aortic valve replacement (SAVR or TAVI) between 2018 and 2021. Technical success of the procedure, need for early reintervention, length of hospital stay, in-hospital mortality, and peri-interventional complications were analyzed. The Kruskal-Wallis test was used to compare numerical variables, and the Chi-square test for categorical variables.</span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Results</strong>: Results from 706 intervened patients were analyzed (n=320 SAVR, n=386 TAVI). The technical success of the procedure was similar in both groups (96.5% surgery vs. 96.4% TAVI, p=0.13). Patients undergoing surgery showed a higher need for early reintervention (8.8%) compared to TAVI (1.6%, p<0.001), whereas the TAVI group exhibited a higher prevalence of stroke (1.6% surgery vs. 4.6% TAVI, p=0.04) and the need for pacemaker implantation (7.8% surgery vs. 20.7% TAVI, p<0.001). No differences were detected in other peri-interventional complications, including acute heart failure, recovered cardiac arrest, major bleeding, myocardial infarction, coronary ostium occlusion/dissection, atrial fibrillation, or delirium. The length of hospitalization was significantly longer in the SAVR group (18 ± 13.5 days) compared to TAVI (13 ± 9.7). No differences were detected in in-hospital mortality.</span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Conclusions</strong>: This study suggests that both SAVR and TAVI offer similar rates of technical success in treating severe AS. No significant differences were found in in-hospital mortality or in most peri-interventional complications between both groups. However, there is room for improvement to prevent complications associated with both procedures.</span></span></span></p>
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