초록접수 현황
| 16F-079 | 구연 발표 |
Transcatheter Aortic Valve Implantation and Conventional Aortic Valve Replacement in Severe Aortic Stenosis: A Propensity Score Matched Analysis
Jihoon Kim, Suk Jung Choo, Jun Bum Kim, Sung-Ho Jung, Cheol Hyun Chung, Jae Won Lee
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
Background : Recently, transcatheter aortic valve implantation (TAVI) emerged as an alternative treatment option even in intermediate-risk patients with severe aortic stenosis (AS). We aimed to compare the clinical outcomes of TAVI and conventional aortic valve replacement (AVR) in a single institution.
Methods : We retrospectively investigated 648 patients with severe aortic stenosis who underwent TAVI (n=189) or isolated AVR (n=459) in our institution from March 2010 to February 2016. To reduce the impact of treatment selection bias, a propensity matching model was used based on 23 baseline covariates.
Results : In the entire cohort, the early mortality rates were 3.7% in the TAVI group (7/189) and 0.7% in the AVR group (3/459; P=0.008). During follow-up (median 33.3 months, quartile 1-3, 17.5-50.4 months), 87 patients died (35 in the TAVI and 52 in the AVR groups) showing 3-year survival rates of 82.4% and 89.3% in the TAVI and AVR groups, respectively. Propensity score matching yielded 112 pairs of patients well-balanced for all measurable baseline profiles. After matching, there were no significant differences in the risks of early mortality (OR, 4.11; 95% CI, 0.60-81.11; P=0.21) and overall mortality (HR, 0.67; 95% CI 0.11-4.04, P=0.29; Figure) between the two groups. In addition, there were no significant impact of the procedural type on a composite risk of stroke, valve reoperation and infective endocarditis (HR, 0.67; 95% CI, 0.11-4.04; P=0.67).
Conclusion : In the current single center experience, TAVI revealed comparable outcomes with conventional AVR. Further studies are warranted to address issues of long-term clinical outcomes and prosthetic valve durability.
Methods : We retrospectively investigated 648 patients with severe aortic stenosis who underwent TAVI (n=189) or isolated AVR (n=459) in our institution from March 2010 to February 2016. To reduce the impact of treatment selection bias, a propensity matching model was used based on 23 baseline covariates.
Results : In the entire cohort, the early mortality rates were 3.7% in the TAVI group (7/189) and 0.7% in the AVR group (3/459; P=0.008). During follow-up (median 33.3 months, quartile 1-3, 17.5-50.4 months), 87 patients died (35 in the TAVI and 52 in the AVR groups) showing 3-year survival rates of 82.4% and 89.3% in the TAVI and AVR groups, respectively. Propensity score matching yielded 112 pairs of patients well-balanced for all measurable baseline profiles. After matching, there were no significant differences in the risks of early mortality (OR, 4.11; 95% CI, 0.60-81.11; P=0.21) and overall mortality (HR, 0.67; 95% CI 0.11-4.04, P=0.29; Figure) between the two groups. In addition, there were no significant impact of the procedural type on a composite risk of stroke, valve reoperation and infective endocarditis (HR, 0.67; 95% CI, 0.11-4.04; P=0.67).
Conclusion : In the current single center experience, TAVI revealed comparable outcomes with conventional AVR. Further studies are warranted to address issues of long-term clinical outcomes and prosthetic valve durability.
책임저자: Suk Jung Choo
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
발표자: Suk Jung Choo, E-mail : sjchoo@amc.seoul.kr