Impact of On-Site Cardiac Surgery on Clinical Outcomes After Transfemoral Transcatheter Aortic Valve Replacement

Florian Egger*, David Zweiker, Matthias K. Freynhofer, Verena Loeffler, Miklos Rohla, Alexander Geppert, Serdar Farhan, Birgit Vogel, Juergen Falkensammer, Johannes Kastner, Philipp Pichler, Paul Vock, Gudrun Lamm, Olev Luha, Albrecht Schmidt, Daniel Scherr, Matthias Hammerer, Uta C. Hoppe, Edwin Maurer, Michael GrundThomas Lambert, Wolfgang Tkalec, Thomas Sturmberger, Eduard Zeindlhofer, Martin Grabenwoeger, Kurt Huber, Austrian TAVI Group

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    10 Citations (Web of Science)

    Abstract

    OBJECTIVES This study sought to investigate the outcome of high-risk and inoperable patients with severe symptomatic aortic stenosis undergoing transfemoral transcatheter aortic valve replacement (TAVR) in hospitals with (iOSCS) versus without institutional on-site cardiac surgery (no-iOSCS).

    BACKGROUND Current guidelines recommend the use of TAVR only in institutions with a department for cardiac surgery on site.

    METHODS In this analysis of the prospective multicenter Austrian TAVI registry, 1,822 consecutive high-risk patients with severe symptomatic aortic stenosis undergoing transfemoral TAVR were evaluated. A total of 290 (15.9%) underwent TAVR at no-iOSCS centers (no-iOSCS group), whereas the remaining 1,532 patients (84.1%) were treated in iOSCS centers (iOSCS group).

    RESULTS Patients of the no-iOSCS group had a higher perioperative risk defined by the logistic EuroSCORE (20.9% vs. 14.2%; p

    CONCLUSIONS Patients undergoing transfemoral TAVR in hospitals without iOSCS had a significantly higher baseline risk profile. After propensity score matching short-and long-term mortality was similar between centers with and without iOSCS. (c) 2018 by the American College of Cardiology Foundation.

    Original languageEnglish
    Pages (from-to)2160-2167
    Number of pages8
    JournalJacc-Cardiovascular Interventions
    Volume11
    Issue number21
    DOIs
    Publication statusPublished - 12 Nov 2018

    Keywords

    • aortic stenosis
    • on-site cardiac surgery
    • TAVR
    • transfemoral
    • IMPLANTATION TAVI INSIGHTS
    • VALVULAR HEART-DISEASE
    • EDWARDS SAPIEN
    • TASK-FORCE
    • REGISTRY
    • MANAGEMENT
    • STENOSIS
    • SOCIETY

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