Aortic Valve Repair Results in Better 1-Year Survival Than Replacement: Results From German Aortic Valve Registry
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Aortic Valve Repair Results in Better 1-Year Survival Than Replacement: Results From German Aortic Valve Registry. / Girdauskas, Evaldas; Balaban, Ümniye; Herrmann, Eva; Bauer, Timm; Beckmann, Andreas; Bekeredjian, Raffi; Ensminger, Stephan; Frerker, Christian; Möllmann, Helge; Petersen, Johannes; Walther, Thomas; Bleiziffer, Sabine.
In: ANN THORAC SURG, Vol. 117, No. 3, 03.2024, p. 517-525.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Aortic Valve Repair Results in Better 1-Year Survival Than Replacement: Results From German Aortic Valve Registry
AU - Girdauskas, Evaldas
AU - Balaban, Ümniye
AU - Herrmann, Eva
AU - Bauer, Timm
AU - Beckmann, Andreas
AU - Bekeredjian, Raffi
AU - Ensminger, Stephan
AU - Frerker, Christian
AU - Möllmann, Helge
AU - Petersen, Johannes
AU - Walther, Thomas
AU - Bleiziffer, Sabine
N1 - Copyright © 2024 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
PY - 2024/3
Y1 - 2024/3
N2 - BACKGROUND: Aortic valve (AV) repair is an evolving surgical strategy in the treatment of nonelderly adults with aortic regurgitation. We aimed to determine the 1-year outcome after AV repair vs surgical AV replacement (sAVR) using real-world data from the German Aortic Valve Registry.METHODS: A total of 8076 aortic regurgitation patients (mean age, 59.1 ± 15.0 years; 76% men; mean The Society of Thoracic Surgeons score, 1.3 ± 1.1), who underwent AV surgical procedures between 2011 and 2015, were identified from German Aortic Valve Registry. The AV was repaired in 2327 patients (29%), and the remaining 5749 patients (71%) underwent sAVR. A weighted propensity score model, including the variables of age, sex, and The Society of Thoracic Surgeons score, was used to correct for baseline differences between AV repair and sAVR cohorts. The primary end point was 1-year survival after AV repair vs sAVR. Secondary end points were freedom from cardiac events and AV reinterventions.RESULTS: Survival at 1 year was 97.7% (95% CI, 97.0%-98.5%) in the AV repair cohort vs 96.4% (95% CI, 95.9%-96.9%) in the propensity score-weighted sAVR cohort (log-rank P < .001). Cox regression revealed a significant advantage of AV repair vs sAVR (hazard ratio, 0.68; 95% CI, 0.51-0.90; P < .0001) on 1-year survival, which was independent of age. Cardiac event-free survival at 1 year was 85.7% (95% CI, 483.8%-87.7%) in the AV repair group vs 81.7% (95% CI, 80.7%-82.9%) in the sAVR group (log-rank P < .001). AV reintervention was required in 38 AV repair patients (1.6%) compared with 1.6% in the sAVR cohort (P = .59).CONCLUSIONS: AV repair surgery, whenever intraoperatively feasible, is associated with a significantly better 1-year survival and 1-year cardiac event-free survival compared with sAVR.
AB - BACKGROUND: Aortic valve (AV) repair is an evolving surgical strategy in the treatment of nonelderly adults with aortic regurgitation. We aimed to determine the 1-year outcome after AV repair vs surgical AV replacement (sAVR) using real-world data from the German Aortic Valve Registry.METHODS: A total of 8076 aortic regurgitation patients (mean age, 59.1 ± 15.0 years; 76% men; mean The Society of Thoracic Surgeons score, 1.3 ± 1.1), who underwent AV surgical procedures between 2011 and 2015, were identified from German Aortic Valve Registry. The AV was repaired in 2327 patients (29%), and the remaining 5749 patients (71%) underwent sAVR. A weighted propensity score model, including the variables of age, sex, and The Society of Thoracic Surgeons score, was used to correct for baseline differences between AV repair and sAVR cohorts. The primary end point was 1-year survival after AV repair vs sAVR. Secondary end points were freedom from cardiac events and AV reinterventions.RESULTS: Survival at 1 year was 97.7% (95% CI, 97.0%-98.5%) in the AV repair cohort vs 96.4% (95% CI, 95.9%-96.9%) in the propensity score-weighted sAVR cohort (log-rank P < .001). Cox regression revealed a significant advantage of AV repair vs sAVR (hazard ratio, 0.68; 95% CI, 0.51-0.90; P < .0001) on 1-year survival, which was independent of age. Cardiac event-free survival at 1 year was 85.7% (95% CI, 483.8%-87.7%) in the AV repair group vs 81.7% (95% CI, 80.7%-82.9%) in the sAVR group (log-rank P < .001). AV reintervention was required in 38 AV repair patients (1.6%) compared with 1.6% in the sAVR cohort (P = .59).CONCLUSIONS: AV repair surgery, whenever intraoperatively feasible, is associated with a significantly better 1-year survival and 1-year cardiac event-free survival compared with sAVR.
KW - Male
KW - Humans
KW - Adult
KW - Middle Aged
KW - Aged
KW - Female
KW - Aortic Valve/surgery
KW - Transcatheter Aortic Valve Replacement/methods
KW - Heart Valve Prosthesis Implantation/methods
KW - Aortic Valve Insufficiency/surgery
KW - Aortic Valve Stenosis/surgery
KW - Treatment Outcome
KW - Risk Factors
KW - Registries
U2 - 10.1016/j.athoracsur.2023.07.051
DO - 10.1016/j.athoracsur.2023.07.051
M3 - SCORING: Journal article
C2 - 37625612
VL - 117
SP - 517
EP - 525
JO - ANN THORAC SURG
JF - ANN THORAC SURG
SN - 0003-4975
IS - 3
ER -
