University of Oulu

Mariscalco, G., D’Errigo, P., Biancari, F., Rosato, S., Musumeci, F., Barbanti, M. ... Seccareccia, F. (2020). Early and late outcomes after transcatheter versus surgical aortic valve replacement in obese patients. Archives of Medical Science, 16(4), 796-801. https://doi.org/10.5114/aoms.2019.85253

Early and late outcomes after transcatheter versus surgical aortic valve replacement in obese patients

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Author: Mariscalco, Giovanni1,2; D’Errigo, Paola3; Biancari, Fausto4,5,6;
Organizations: 1Department of Cardiac Surgery, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
2Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
3Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
4Heart Center, Turku University Hospital, Turku, Finland
5Department of Surgery, University of Turku, Turku, Finland
6Department of Surgery, University of Oulu, Oulu, Finland
7Department of Cardiovascular Sciences, Cardiac Surgery Unit, S. Camillo-Forlanini Hospital, Rome, Italy
8Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy
9Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
10Ospedale Careggi di Firenze, Florence, Italy
11Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.1 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2021101250729
Language: English
Published: Termedia, 2020
Publish Date: 2021-10-12
Description:

Abstract

Introduction:Data on the early and late outcome following transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in obese patients are limited. We investigated whether TAVI may be superior to SAVR in obese patients.

Material and methods:Obese patients (body mass index ≥ 30 kg/m²) who underwent either SAVR or TAVI were identified from the nationwide OBSERVANT registry, and their in-hospital and long-term outcomes were analysed. Propensity score matching was employed to identify two cohorts with similar baseline characteristics.

Results:The propensity score matching provided 142 pairs balanced in terms of baseline risk factors. In-hospital and 30-day mortality did not differ between SAVR and TAVI obese patients (4.6% vs. 3.3%, p = 0.56, and 5.2% vs. 3.2%, p = 0.41, respectively). Obese SAVR patients experienced a higher rate of renal failure (12.4% vs. 3.6%, p = 0.0105) and blood transfusion requirement (60.3% vs. 25.7%, p < 0.0001) in comparison with TAVI patients. A higher rate of permanent pacemaker implantation (14.4% vs. 3.6%, p = 0.0018), and major vascular injuries (7.4% vs. 0%, p = 0.0044) occurred in the TAVI group. Five-year survival was higher in the SAVR group compared to the TAVI patient cohort (p = 0.0046), with survival estimates at 1, 3 and 5 years of 88.0%, 80.3%, 71.8% for patients undergoing SAVR, and 85.2%, 69.0%, 52.8% for those subjected to TAVI procedures.

Conclusions:In obese patients, both SAVR and TAVI are valid treatment options, although in the long term SAVR exhibited higher survival rates.

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Series: Archives of medical science
ISSN: 1734-1922
ISSN-E: 1896-9151
ISSN-L: 1734-1922
Volume: 16
Issue: 4
Pages: 796 - 801
DOI: 10.5114/aoms.2019.85253
OADOI: https://oadoi.org/10.5114/aoms.2019.85253
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
3126 Surgery, anesthesiology, intensive care, radiology
Subjects:
Funding: The OBSERVANT Study was supported by a grant (Fasc. 1M30) from the Italian Ministry of Health and Istituto Superiore di Sanità. The study has been further supported by the Italian Ministry of Health within the call “Ricerca Finalizzata 2016” (code PE-2016-02364619).
Copyright information: © 2019 Termedia & Banach. Creative Commons licenses: This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY -NC -SA 4.0). License (http://creativecommons.org/licenses/by-nc-sa/4.0/).
  https://creativecommons.org/licenses/by-nc-sa/4.0/