gms | German Medical Science

129. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

24.04. - 27.04.2012, Berlin

TAVI versus conventional Aortic Valve Replacement for patients with prior cardiac surgery – Experience with 151 Patients

Meeting Abstract

  • Sems-Malte Tugtekin - Herzzentrum Dresden, Herzchirurgie, Dresden
  • Manuel Wilbring - Herzzentrum Dresden, Herzchirurgie, Dresden
  • Konstantin Alexiou - Herzzentrum Dresden, Herzchirurgie, Dresden
  • K. Matschke - Herzzentrum Dresden, Herzchirurgie, Dresden
  • Utz Kappert - Herzzentrum Dresden, Herzchirurgie, Dresden

Deutsche Gesellschaft für Chirurgie. 129. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 24.-27.04.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12dgch174

DOI: 10.3205/12dgch174, URN: urn:nbn:de:0183-12dgch1741

Published: April 23, 2012

© 2012 Tugtekin et al.
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Outline

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Introduction: Redo aortic valve replacement with the use of Transcatheter aortic valve implantation (TAVI) represents an increasing alternative to conventional surgical redo aortic valve replacement (cAVR) procedures. Clinical outcome and morbidity of both procedures were assessed with concern of the applied technique.

Materials and methods: In a retrospective observational, comparative study, 151 (104 male, 47 female) consecutive patients underwent redo AVR either with cAVR operation (n=121; 80.1%) or with TAVI with a transapical access (n=30; 19.9%). Prior procedure were AVR (n=65; 43.1%) or CABG (n=86; 56.9%). Primary endpoints were clinical outcome and morbidity during 30 days.

Results: TAVI patients were older (78.2 ± 6 vs 72.0 ± 8 years; p < 0.001) and presented higher logistic (28.1 ± 9.5 vs 22.7 ± 14; p =0.05) European System for Cardiac Operative Risk Evaluation scores. All-cause mortality was 5.3 % in both groups (10% TAVI versus 4.13% cAVR, p= 0.08). Cerebrovascular event rates were comparable (0% TAVI vs 1.9% cAVR, p = 0.32) after 30 days. Incidence of renal failure was increased after TAVI (10.00% versus 6.19%; p= 0.22).

Conclusion: In elderly, high-risk patients after prior cardiac surgery, conventional aortic valve replacement and TAVI are comparable treatment options. The decision for the selected approach of a redo operation must still be individualized even in the setting of increasing TAVI procedures.