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GARY data provide comprehensive look at aortic valve replacement procedures
Conventional aortic valve replacement surgery was associated with encouraging mortality outcomes at 1 year in low-risk patients, while transcatheter intervention was shown to be a good alternative to surgery in high-risk and elderly patients, according to findings from the German Aortic Valve Registry.
The aim of the registry, according to Friedrich W. Mohr, MD, study investigator with the Heart Center Leipzig in Leipzig, Germany, was to obtain a comprehensive and contemporary picture of the current practice of aortic valve intervention therapy and to create an independent database that will allow for long-term follow-up of these patients.
“The acceptance of this voluntary registry is demonstrated by the fact that 55% of all aortic valve procedures performed in Germany in 2011 were included, with an increasing recruitment rate observed in 2012,” Mohr said in a press release. “In addition, a good follow-up rate of 98.5% with regards to vital status and 90% for clinical information was achieved.”
For the current analysis of the German Aortic Valve Registry (GARY), Mohr and researchers culled data for 13,860 consecutive patients treated at 78 centers in Germany during 2011.
The researchers gathered baseline, quality of life and procedural and outcome data up to 1 year after intervention for 98.1% of the cohort.
Conventional AVR (n=6,523) yielded a 1-year mortality rate of 6.7% compared with 11% among 3,464 patients who underwent aortic valve replacement with CABG.
Among 2,695 patients undergoing transvascular TAVR, the 1-year mortality rate was 20.7% compared with 28% for the 1,181 patients who received transapical TAVR.
The researchers further stratified patients into four risk groups based on EuroSCORE and the German AV Score. Results of this analysis indicated that 1-year mortality rates in the highest-risk groups were the same for conventional and catheter-based interventions.
Follow-up data at 1 year after intervention indicated that more than 80% of the cohort was in the same or better state of health. These findings also indicated that patients were satisfied with the outcome of the procedure.
Mohr added in the press release that the findings confirm that conventional surgery remains an attractive option in real-world situations. “Continuation of the registry and long-term follow-up will help to develop robust future risk models to predict patient outcomes for each treatment option in patients with aortic stenosis,” he said.
Disclosure: Mohr reports no relevant financial disclosures. Other researchers report financial disclosures with Adrian-Medtronic, AstraZeneca, AWD Dresden, Bayer AG, Berlin-Chemie, Boehringer Ingelheim, Daiichi Sankyo, Edwards Lifesciences, Medtronic, MSD, Novartis, Pfizer, Sanofi Aventis, Servier and Symetis.