Comparison of transcatheter versus surgical aortic valve implantation in high-risk patients: A nationwide study in France

The Journal of Thoracic and Cardiovascular Surgery
Xavier ArmoiryAntoine Duclos

Abstract

To compare the clinical outcomes and direct costs at 5 years between transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) using real-world evidence. We performed a nationwide longitudinal study using data from the French Hospital Information System from 2009 to 2015. We matched, inside hospitals, 2 cohorts of adults who underwent TAVI or SAVR during 2010 on propensity score based on patient characteristics. Outcomes analysis included mortality, morbidity, and total costs and with a maximum 60-month follow-up. Clinical outcomes were compared between cohorts using hazard ratios (HRs) estimated from a Cox proportional hazards model for all-cause death, and from Fine and Gray's competing risk model for morbidity. Based on a cohort of 1598 patients (799 in each group) from 27 centers, a higher risk of death was observed after 1 year with TAVI compared with SAVR (16.8% vs 12.8%, respectively; HR, 1.33; 95% confidence interval [CI], 1.02-1.72) and was sustained up to 5 years (52.4% vs 37.2%; HR, 1.56; 95% CI, 1.33-1.84). At 5 years, the risk of stroke was increased (HR, 1.64; 95% CI, 1.07-2.54) as was myocardial infarction (HR, 2.30; 95% CI, 1.12-4.69) and pacemaker implantation (HR, 2.40; 95% CI...Continue Reading

Citations

Jan 29, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Giuseppe SantarpinoMarco Di Eusanio
Nov 2, 2019·The Journal of Cardiovascular Surgery·Hisato TakagiUNKNOWN All-Literature Investigation of Cardiovascular Evidence (ALICE) Group
Apr 1, 2019·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Torsten DoenstGloria Faerber
Jul 18, 2020·Critical Care : the Official Journal of the Critical Care Forum·Enrique GuilhermeJean-Luc Fellahi
Jul 1, 2020·Journal of Cardiothoracic Surgery·Marko P O VirtanenFausto Biancari
Oct 11, 2019·Journal of Cardiac Surgery·Callum HowardAmer Harky
Nov 26, 2020·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Ilies BouabdallahPascal Alexandre Thomas
May 5, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Friedhelm BeyersdorfUNKNOWN GARY Executive Board

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