Aortic valve replacement in Germany in 2019
- 2 January 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Clinical Research in Cardiology
- Vol. 110 (3), 460-465
- https://doi.org/10.1007/s00392-020-01788-6
Abstract
Aims Both surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) are established options to treat aortic valve stenosis. We present the outcome of the complete cohort of all patients undergoing SAVR or TAVI in Germany during the calendar year 2019. Methods and results Data concerning all isolated aortic valve procedures performed in Germany in 2019 were retrieved from the mandatory nationwide quality control program: 22,973 transvascular (TV)-TAVI procedures, 7905 isolated SAVR (iSAVR), and 1413 transapical (TA)-TAVI. Data was complete in 99.9% (n = 32,156). In-hospital mortality after TV-TAVI (2.3%) was significantly lower when compared with iSAVR (2.8%, p = 0.007) or TA-TAVI (6.3%; p < 0.001). Expected mortality was calculated with a new version of the German Aortic valve score (AKL Score) based on the data of either catheter-based (AKL-CATH) or surgical (AKL-CHIR) aortic valve replacements in Germany in 2018. TV-TAVI and iSAVR both showed lower observed mortality in 2019 than expected based on their respective performance in 2018, yielding an observed/expected (O/E) mortality ratio < 1. This was particularly apparent for patients at low risk. After exclusion of emergency procedures, in-hospital mortality after TV-TAVI (2.1%) and after iSAVR (2.1%) was identical, even though patients undergoing TV-TAVI showed a considerably higher perioperative risk profile. Conclusion After excluding emergency procedures, in-hospital mortality of TV-TAVI and iSAVR in 2019 in Germany was identical. In 2019, TV-TAVI and iSAVR both show lower matched mortality ratios compared with 2018, which suggests technical improvements of both therapies. Graphical abstractKeywords
This publication has 10 references indexed in Scilit:
- Lower mortality in an all-comers aortic stenosis population treated with TAVI in comparison to SAVRClinical Research in Cardiology, 2019
- Transvascular transcatheter aortic valve implantation in 2017Clinical Research in Cardiology, 2019
- Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk PatientsThe New England Journal of Medicine, 2019
- Outcome after transvascular transcatheter aortic valve implantation in 2016European Heart Journal, 2017
- Corrigendum to: 2017 ESC/EACTS Guidelines for the management of valvular heart diseaseEuropean Heart Journal, 2017
- Surgical or Transcatheter Aortic-Valve Replacement in Intermediate-Risk PatientsThe New England Journal of Medicine, 2017
- Temporal trends in transcatheter and surgical aortic valve replacementHerz, 2016
- Transcatheter aortic valve replacement versus surgical valve replacement in intermediate-risk patients: a propensity score analysisThe Lancet, 2016
- Transcatheter versus Surgical Aortic-Valve Replacement in High-Risk PatientsThe New England Journal of Medicine, 2011