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Eur J Cardiothorac Surg. 2014 Nov;46(5):808-16. doi: 10.1093/ejcts/ezu290. Epub 2014 Jul 30.

The German Aortic Valve Registry: 1-year results from 13,680 patients with aortic valve disease.

Author information

1
Heart Center Leipzig, Leipzig, Germany mohrf@medizin.uni-leipzig.de friedrich.mohr@herzzentrum-leipzig.de.
2
Heart Center Leipzig, Leipzig, Germany.
3
Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany.
4
Deutsche Gesellschaft für Thorax-, Herz- und Gefäßchirurgie, Langenbeck-Virchow-Haus, Berlin, Germany.
5
BQS Institute for Quality and Patient Safety, Düsseldorf, Germany.
6
Division of Cardiology, 1st Department of Medicine, University Hospital of Jena, Jena, Germany.
7
Department of Cardiovascular Surgery, University of Schleswig-Holstein, Kiel, Germany.
8
Asklepios Klinik St. Georg, Hamburg, Germany.
9
German Heart Center Munich, Department of Cardiovascular Surgery, Technische Universität München, Munich, Germany.
10
Department of Cardiology, Medizinische Klinik B, Herzzentrum am Klinikum Ludwigshafen, Ludwigshafen, Germany.
11
Klinik für Kardiologie, Pneumologie und Internistische Intensivmedizin, Klinikum Schwabing, Munich, Germany.
12
Kerckhoff-Herzzentrum, Abteilung für Herzchirurgie, Bad Nauheim, Germany.
13
Universitätsklinikum Freiburg, Chirurgische Klinik Abteilung Herz- und Gefäßchirurgie, Freiburg, Germany.
14
Medizinische Klinik und Poliklinik, Universitätsklinik des Saarlandes, Innere Medizin III, Homburg/Saar, Germany.
15
Institut für Pathophysiologie, Universitätsklinikum Essen, Essen, Germany.
16
Deutsche Herzstiftung, Frankfurt am Main, Germany.
17
Department of Cardiology, University of Duisburg-Essen Medical School, Essen, Germany.
18
German Cardiac Society, Düsseldorf, Germany.
19
Institut für Herzinfarktforschung, Ludwigshafen, Germany.
20
Department of Cardiac Surgery, University of Bonn, Bonn, Germany.

Abstract

OBJECTIVES:

The German Aortic Valve Registry (GARY) seeks to provide information on a real-world, all-comers basis for patients undergoing aortic valve interventions. This registry comprises patients undergoing the complete spectrum of transcutaneous and conventional surgical aortic valve interventions. The aim of this study was to use the GARY registry to evaluate conventional and catheter-based aortic valve interventions in several risk groups.

METHODS:

A total of 13 860 consecutive patients undergoing intervention for aortic valve disease [conventional aortic valve replacement (AVR) or transvascular/transapical TAVR (TV-/TA-TAVR)] were enrolled in 78 German centres in 2011. Baseline, procedural and outcome data, including quality of life, were acquired up to 1 year post-intervention. Vital status at 1 year was known for 98.1% of patients.

RESULTS:

The 1-year mortality rate was 6.7% for conventional AVR patients (n = 6523) and 11.0% for patients who underwent AVR with coronary artery bypass grafting (n = 3464). The 1-year mortality rate was 20.7 and 28.0% in TV- and TA-TAVR patients, respectively (n = 2695 and 1181). However, if patients were stratified into four risk groups by means of the EuroSCORE and the German AV Score, the highest risk cohorts showed the same mortality at 1 year with either therapy. More than 80% of patients in all groups were in the same or better state of health at 1 year post-intervention and were satisfied with the procedural outcome.

CONCLUSIONS:

Conventional AVR surgery yields excellent results after 1 year in lower-risk patients. Catheter-based AVR is a good alternative in high-risk and elderly patients.

KEYWORDS:

Aortic valve interventions; Aortic valve registry; Catheter-based valve replacement; One-year mortality; Risk groups

Comment in

PMID:
25079769
DOI:
10.1093/ejcts/ezu290
[Indexed for MEDLINE]

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