, Michal Hawranek 1
, Wojciech Wojakowski 2
, Piotr Chodór 3
, Michal Zembala 4
, Pawel Buszman 5
, Andrzej Bochenek 5
, Marek Deja 6
, Maciej Dyrbus 7
, Daniel Ciesla 1
, Zbigniew Kalarus 3
, Mariusz Gasior 1
, Marian Zembala 4
2Department Of Cardiology And Structural Heart Diseases, 3rd Division Of Cardiology, Medical University Of Silesia, Katowice, Poland
3Department Of Cardiology, Congenital Heart Diseases And Electrotherapy, Silesian Centre For Heart Disease In Zabrze, Medical University Of Silesia, Katowice, Poland
4Department Of Cardiac, Vascular And Endovascular Surgery And Transplantology, Medical University Of Silesia, Katowice, Poland, Silesian Centre For Heart Disease In Zabrze, Poland
5American Heart Of Poland, Katowice, Poland
6Department Of Cardiac Surgery, Medical University Of Silesia, Katowice, Poland
7Student Scientific Society, 3rd Department Of Cardiology, School Of Medical Sciences In Zabrze, Medical University Of Silesia, Katowice, Poland.
Abstract
Background: Data concerning the comparison between transcatheter aortic valve implantation and surgical aortic valve replacement in a real-world setting are scarce and in Central and Eastern Europe no such data exist. In this study, we aimed at analyzing retrospectively the characteristics and outcome of patients with aortic stenosis treated either with surgical aortic valve replacement or transcatheter aortic valve implantation between 2006 and 2016 in the Silesian Province, Poland in a representative real-world cohort.
Methods: In the Silesian Cardiovascular Database we retrospectively identified 5186 patients who received either transcatheter aortic valve implantation or surgical aortic valve replacement in 1 of 3 tertiary cardiovascular centers. Baseline characteristics, including relevant clinical history, and outcomes were compared before and after propensity-score matching of both groups, with 348 pairs of patients constituting the
propensity-matched study cohort. The primary end-point was 24-month all-cause mortality.
Results: Preoperative characteristics of propensity-matched groups were similar. There was no difference between transcatheter aortic valve implantation and surgical aortic valve replacement groups with respect to the death rate at 2 years (19.9% vs. 15.6%; P =
.479). In the transcatheter aortic valve implantation group, cardiac resynchronization therapy devices were more frequently implanted after the procedure (3.7% vs. 0.0, P <.001). The groups had similar rates of myocardial infarction, stroke, and re-hospitalization. Hospital stay in the matched groups was shorter after transcatheter aortic valve implantation: 14.1 versus 15.7 days (P <.001).
Conclusions: At 24 months, transcatheter aortic valve implantation patients had similar outcomes as surgical aortic valve replacement except for a higher rate of cardiac resynchronization therapy device implantation and shorter hospital stay.