Comparison of Early Clinical Results of Transcatheter versus Surgical Aortic Valve Replacement in Symptomatic High Risk Severe Aortic Stenosis Patients

대한흉부외과학회지 2013년 46권 5호 p.346 ~ p.352

유우식(Yu Woo-Sik) - Yonsei University College of Medicine Department of Thoracic and Cardiovascular Surgery
장병철(Chang Byung-Chul) - Yonsei University College of Medicine Department of Thoracic and Cardiovascular Surgery
주현철(Joo Hyun-Chel) - Yonsei University College of Medicine Department of Thoracic and Cardiovascular Surgery
고영국(Ko Young-Guk) - Yonsei University College of Medicine Department of Cardiology
이삭(Lee Sak) - Yonsei University College of Medicine Department of Thoracic and Cardiovascular Surgery

Abstract

Background: Transcatheter aortic valve implantation (TAVI) has been an alternative to conventional aortic valve re-placement (AVR) in old and high risk patients. The goal of this study is to compare the early outcomes of con-ventional AVR vs. TAVI in high risk severe AS patients.

Methods: From January 2008 to July 2012, 44 high risk severe aortic stenosis patients underwent conventional AVR, and 15 patients underwent TAVI. We compared echo-cardiographic data, periprocedural complication, and survival. The mean follow-up duration was 14.5±10 months (AVR), and 6.8±3.5 months (TAVI), respectively.

Results: AVR group was younger (78.2±2.4 years vs. 82.2±3.0 years, p<0.001) and had lower operative risk (Euroscore: 9.4±2.7 vs. 11.0±2.0, p=0.044) than TAVI group. There was no significant difference in early mortality (11.4% vs. 13.3%, p=0.839), and 1 year survival (87.4%±5.3% vs. 83.1%±1.1%, p=0.805). There was no significant difference in postoperative functional class. There was no sig-nificant difference in periprocedural complication except vascular complication (0% [AVR] vs. 13.3% [TAVI], p=0.014). TAVI group had more moderate and severe paravalvular leakage.

Conclusion: In this study, both groups had sim-ilar periprocedural morbidity, and mortality. However, TAVI group had more greater than moderate paravalvular leak-age, which can influence long-term outcome. Since more patients are treated with TAVI even in moderate risk, careful selection of the patients and appropriate guideline need to be established.

키워드

Aortic valve stenosis, Aortic valve, surgery, Transcatheter aortic valve implantation
원문 및 링크아웃 정보
등재저널 정보
학술진흥재단(KCI) KoreaMed 대한의학회 회원 
주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
In this study, the TAVI group had a similar 1-year survival to the AVR group despite the fact that TAVI was performed in older and higher risk patients; AVR group was younger (78.2±2.4 years vs. 82.2±3.0 years, p<0.001) and had lower operative risk (Euroscore: 9.4±2.7 vs. 11.0±2.0, p=0.044) than TAVI group. There was no significant difference in early mortality (11.4% vs. 13.3%, p=0.839), and 1 year survival (87.4%±5.3% vs. 83.1%±1.1%, p=0.805).
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
KCD코드
ICD 03
건강보험코드