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GARY data show strong results for TAVR in elderly patients with AF
Low stroke and in-hospital mortality rates were reported for conventional surgery and catheter-based interventions in a cohort of older patients with atrial fibrillation, according to results from the German Aortic Valve Registry published in the European Heart Journal.
Catheter-based valve implantation is an emerging treatment approach for older patients with AF who are at high risk for surgery or inoperable. Christian Hamm, MD,with the Kerckhoff Heart and Thorax Center, University of Giessen, Germany, and fellow researchers enrolled 13,860 consecutive patients during 2011 from the German Aortic Valve Registry (GARY), which offers data on conventional and catheter-based aortic procedures.
For the study, Hamm and colleagues analyzed conventional surgery patients and those undergoing transvascular and transapical catheter-based procedures, acquiring baseline, procedural and outcome data.
Christian Hamm
The analysis was comprised of 6,523 conventional aortic valve replacements (AVRs) without CABG, 3,464 AVRs with concomitant CABG, 2,695 transvascular interventions and 1,181 transapical interventions.
Baseline data indicated that patients in the catheter-based groups were significantly older and at increased risk.
Stroke rates were 1.3% for conventional AVR, 1.9% for AVR plus CABG, 1.7% for transvascular interventions and 2.3% for transapical interventions.
Similarly, in-hospital mortality rates were also low across the treatment groups, with a 2.1% rate reported for AVR, 4.5% for AVR plus CABG, 5.1% for transvascular and 7.7% for transapical approaches.
“The in-hospital outcome results of this registry show that conventional surgery yields excellent results in all risk groups and that catheter-based aortic valve replacements is an alternative to conventional surgery in high-risk and elderly patients,” Hamm and colleagues wrote.
Disclosure: The researchers report financial disclosures with Abbott, Edwards, JenaValve, Medtronic, St. Jude Medical, Symetis and the TAVI Company.