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Paola D’Errigo, Fausto Biancari, Stefano Rosato, Corrado Tamburino, Marco Ranucci, Gennaro Santoro, Marco Barbanti, Martina Ventura, Danilo Fusco & Fulvia Seccareccia (2018) Transcatheter aortic valve implantation compared with surgical aortic valve replacement in patients with anaemia, Acta Cardiologica, 73:1, 50-59, DOI: 10.1080/00015385.2017.1327627

Transcatheter aortic valve implantation compared with surgical aortic valve replacement in patients with anaemia

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Author: D’Errigo, Paola1; Biancari, Fausto2; Rosato, Stefano1;
Organizations: 1National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Rome, Italy
2Department of Surgery, Oulu University Hospital, Oulu, Finland
3Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy
4Department of Cardiothoracic and Vascular Anesthesia and ICU - IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
5Division of Cardiology, Careggi Hospital, Florence, Italy
6Department of Epidemiology of Lazio Regional Health Service, Rome, Italy
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2019101532710
Language: English
Published: Informa, 2018
Publish Date: 2019-10-15
Description:

Abstract

Objectives: We compared the outcome of anaemic patients undergoing transcatheter (TAVI) and surgical aortic valve replacement (SAVR) for severe aortic valve stenosis.

Methods: Anaemic patients (haemoglobin <13.0 g/dL in men and <12.0 g/dL in women) undergoing TAVI and SAVR from the OBSERVANT study were the subjects of this analysis.

Results: Preoperative anaemia was an independent predictor of 3-year mortality after either TAVI (HR 1.37, 95% CI 1.12–1.68) and SAVR (HR 1.63, 95% CI 1.37–1.99). Propensity score matching resulted in 302 pairs with similar characteristics. Patients undergoing SAVR had similar 30-d mortality (3.6% versus 3.3%, p = .81) and stroke (1.3% versus 2.0%, p = .53) compared with TAVI. The rates of pacemaker implantation (18.6% versus 3.0%, p < .001), major vascular damage (5.7% versus 0.4%, p < .001) and mild-to-severe paravalvular regurgitation (47.4% versus 9.3%, p < .001) were higher after TAVI, whereas acute kidney injury (50.7% versus 27.9%, p < .001) and blood transfusion (70.0% versus 38.6%, p < .001) were more frequent after SAVR. At 3-year, survival was 74.0% after SAVR and 66.3% after TAVI, respectively (p = .065), and freedom from MACCE was 67.6% after SAVR and 58.7% after TAVI, respectively (p = .049).

Conclusions: These results suggest that TAVI is not superior to SAVR in patients with anaemia.

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Series: Acta cardiologica
ISSN: 0001-5385
ISSN-E: 0001-5385
ISSN-L: 0001-5385
Volume: 73
Issue: 1
Pages: 50 - 59
DOI: 10.1080/00015385.2017.1327627
OADOI: https://oadoi.org/10.1080/00015385.2017.1327627
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Subjects:
Anaemia, anaemic, aortic valve stenosis, TAVR, TAVI, aortic valve replacement
Article
Funding: The OBSERVANT Study was supported by a grant (Fasc. 1M30) from Italian Ministry of Health and Istituto Superiore di Sanità.
Copyright information: © Taylor & Francis 2017. This is an Accepted Manuscript of an article published by Taylor & Francis in Acta Cardiologica on 16.8.2017, available online: http://www.tandfonline.com/10.1080/00015385.2017.1327627.