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 Grund; Thomas Lambert; Wolfgang Tkalec; Thomas Sturmberger; Eduard Zeindlhofer; Martin Grabenwoeger; Kurt Huber; Austrian TAVI Group

doi:10.1016/j.jcin.2018.07.015

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 journal › Article › Academic › peer-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 language	English
Pages (from-to)	2160-2167
Number of pages	8
Journal	Jacc-Cardiovascular Interventions
Volume	11
Issue number	21
DOIs	https://doi.org/10.1016/j.jcin.2018.07.015
Publication status	Published - 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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10.1016/j.jcin.2018.07.015

Cite this

Egger, F., Zweiker, D., Freynhofer, M. K., Loeffler, V., Rohla, M., Geppert, A., Farhan, S., Vogel, B., Falkensammer, J., Kastner, J., Pichler, P., Vock, P., Lamm, G., Luha, O., Schmidt, A., Scherr, D., Hammerer, M., Hoppe, U. C., Maurer, E., ... Austrian TAVI Group (2018). Impact of On-Site Cardiac Surgery on Clinical Outcomes After Transfemoral Transcatheter Aortic Valve Replacement. Jacc-Cardiovascular Interventions, 11(21), 2160-2167. https://doi.org/10.1016/j.jcin.2018.07.015

@article{ac9fd4ad7068466db09cc5aff0b0d1a5,

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

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%; pCONCLUSIONS 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.",

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

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

year = "2018",

month = nov,

day = "12",

doi = "10.1016/j.jcin.2018.07.015",

language = "English",

volume = "11",

pages = "2160--2167",

journal = "Jacc-Cardiovascular Interventions",

issn = "1936-8798",

publisher = "Elsevier Science",

number = "21",

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Egger, F, Zweiker, D, Freynhofer, MK, Loeffler, V, Rohla, M, Geppert, A, Farhan, S, Vogel, B, Falkensammer, J, Kastner, J, Pichler, P, Vock, P, Lamm, G, Luha, O, Schmidt, A, Scherr, D, Hammerer, M, Hoppe, UC, Maurer, E, Grund, M, Lambert, T, Tkalec, W, Sturmberger, T, Zeindlhofer, E, Grabenwoeger, M, Huber, K & Austrian TAVI Group 2018, 'Impact of On-Site Cardiac Surgery on Clinical Outcomes After Transfemoral Transcatheter Aortic Valve Replacement', Jacc-Cardiovascular Interventions, vol. 11, no. 21, pp. 2160-2167. https://doi.org/10.1016/j.jcin.2018.07.015

TY - JOUR

T1 - Impact of On-Site Cardiac Surgery on Clinical Outcomes After Transfemoral Transcatheter Aortic Valve Replacement

AU - Egger, Florian

AU - Zweiker, David

AU - Freynhofer, Matthias K.

AU - Loeffler, Verena

AU - Rohla, Miklos

AU - Geppert, Alexander

AU - Farhan, Serdar

AU - Vogel, Birgit

AU - Falkensammer, Juergen

AU - Kastner, Johannes

AU - Pichler, Philipp

AU - Vock, Paul

AU - Lamm, Gudrun

AU - Luha, Olev

AU - Schmidt, Albrecht

AU - Scherr, Daniel

AU - Hammerer, Matthias

AU - Hoppe, Uta C.

AU - Maurer, Edwin

AU - Grund, Michael

AU - Lambert, Thomas

AU - Tkalec, Wolfgang

AU - Sturmberger, Thomas

AU - Zeindlhofer, Eduard

AU - Grabenwoeger, Martin

AU - Huber, Kurt

AU - Austrian TAVI Group

PY - 2018/11/12

Y1 - 2018/11/12

N2 - 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%; pCONCLUSIONS 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.

AB - 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%; pCONCLUSIONS 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.

KW - aortic stenosis

KW - on-site cardiac surgery

KW - TAVR

KW - transfemoral

KW - IMPLANTATION TAVI INSIGHTS

KW - VALVULAR HEART-DISEASE

KW - EDWARDS SAPIEN

KW - TASK-FORCE

KW - REGISTRY

KW - MANAGEMENT

KW - STENOSIS

KW - SOCIETY

U2 - 10.1016/j.jcin.2018.07.015

DO - 10.1016/j.jcin.2018.07.015

M3 - Article

C2 - 30409272

VL - 11

SP - 2160

EP - 2167

JO - Jacc-Cardiovascular Interventions

JF - Jacc-Cardiovascular Interventions

SN - 1936-8798

IS - 21

ER -