초록접수 현황
| 20F-215 | 구연 발표 |
Transcatheter Aortic Valve Replacement versus Surgical Aortic Valve Replacement plus Ablation in Atrial Fibrillation
Eun Ji Kim1, Ho Jin Kim1, Joon Bum Kim1, Suk Jung Choo1, Do Yoon Kang2, Jung Min Ahn2, Duk Woo Park2, Seung Jung Park2
Department of Thoracic and Cardiovascular Surgey1,
Division of Cardiology2
Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Purpose : Comparative outcomes between transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) combined with ablation in patients with atrial fibrillation (AF) has not been evaluated.
Methods : Between July 2010 and November 2019, we enrolled 130 patients with preoperative AF who underwent TAVR (n=49) or SAVR+ablation (n=81). Clinical outcomes were compared with the use of inverse-probability weighting to reduce selection bias.
Results : The TAVR group was older (81.0±5.1yrs vs. 72.9±5.0yrs, P<0.001) and had higher baseline risk profiles compared with the SAVR group. Early mortality rates were 6.1% and 4.9% in TAVR and SAVR groups, respectively (P=0.77). During follow-up (median, 786 months; inter-quartile range, 407.25-1267.75 months), cumulative rates of late AF were 88.9% in TAVR group and 20.5% in SAVR group (P<0.001). No significant differences, however, were observed in the risks of mortality, stroke, aortic valve reoperation, endocarditis and permanent pacemaker implantation between the two groups both before and after adjustments (Table). At the end of follow-up, 100% of the TAVR patients were taking oral anticoagulation or antiplatelet medications while 19.8% in SAVR group were free of such medications (P=0.002).
Conclusion : In patients with AF, SAVR combined with AF ablation seems to be a more effective treatment to control the rhythm, however, it seemed not to translate to superior clinical outcomes when compared with TAVR.
Methods : Between July 2010 and November 2019, we enrolled 130 patients with preoperative AF who underwent TAVR (n=49) or SAVR+ablation (n=81). Clinical outcomes were compared with the use of inverse-probability weighting to reduce selection bias.
Results : The TAVR group was older (81.0±5.1yrs vs. 72.9±5.0yrs, P<0.001) and had higher baseline risk profiles compared with the SAVR group. Early mortality rates were 6.1% and 4.9% in TAVR and SAVR groups, respectively (P=0.77). During follow-up (median, 786 months; inter-quartile range, 407.25-1267.75 months), cumulative rates of late AF were 88.9% in TAVR group and 20.5% in SAVR group (P<0.001). No significant differences, however, were observed in the risks of mortality, stroke, aortic valve reoperation, endocarditis and permanent pacemaker implantation between the two groups both before and after adjustments (Table). At the end of follow-up, 100% of the TAVR patients were taking oral anticoagulation or antiplatelet medications while 19.8% in SAVR group were free of such medications (P=0.002).
Conclusion : In patients with AF, SAVR combined with AF ablation seems to be a more effective treatment to control the rhythm, however, it seemed not to translate to superior clinical outcomes when compared with TAVR.
첨부파일 : AF TAVR abstract_table.docx
책임저자: Joon Bum Kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University ofUlsan College of Medicine
발표자: Eun Ji Kim, E-mail : kej2683@gmail.com