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Ann Thorac Surg. 2016 Feb;101(2):658-66. doi: 10.1016/j.athoracsur.2015.07.090. Epub 2015 Nov 11.

Current Results of Surgical Aortic Valve Replacement: Insights From the German Aortic Valve Registry.

Author information

1
Heart Center Leipzig, Germany. Electronic address: dholzhey@web.de.
2
Heart Center Leipzig, Germany.
3
Kerckhoff Heart Center, Bad Nauheim, Germany.
4
Deutsche Gesellschaft für Thorax-, Herz- und Gefäßchirurgie, Berlin, Germany.
5
BQS Institute for Quality and Patient Safety, Düsseldorf, Germany.
6
University Hospital of Jena, Jena, Germany.
7
University of Schleswig-Holstein, Kiel, Germany.
8
Asklepios Klinik St. Georg, Hamburg, Germany.
9
German Heart Center Munich, Germany.
10
Klinikum Schwabing, Munich, Germany.
11
Universitätsklinikum Freiburg, Freiburg, Germany.
12
Universitätsklinik des Saarlandes, Homburg/Saar, Germany.
13
Institut für Pathophysiologie, Universitätsklinikum Essen, Essen, Germany.
14
Deutsche Herzstiftung; Frankfurt am Main, Germany.
15
University of Duisburg-Essen Medical School, Essen, Germany.
16
German Cardiac Society, Düsseldorf, Germany.
17
Institut für Herzinfarktforschung, Ludwigshafen, Germany.
18
University of Bonn, Bonn, Germany.

Abstract

BACKGROUND:

Conventional aortic valve replacement (AVR) remains the therapy of choice for many patients with severe aortic valve disease. The unique German Aortic Valve Registry (GARY) allows the comparison of contemporary outcomes of AVR with those of transcatheter AVRs. We report here real-world, all-comers outcomes of AVR, including combined AVR and coronary bypass grafting (AVR+CABG).

METHODS:

A total of 34,063 patients who received AVR (22,107 patients, 39% female; mean age 68.0 ± 11.3 years, mean logistic European System for Cardiac Operative Risk Evaluation, 8.6%) or AVR+CABG (11,956 patients, 28% female; mean age 72.6 ± 7.8 years, mean logistic European System for Cardiac Operative Risk Evaluation, 10.7%) between 2011 and 2013 were analyzed and followed up to assess the 1-year outcome.

RESULTS:

In-hospital mortality was 2.3% for AVR and 4.1% for AVR+CABG. Other important outcome variables include stroke (AVR, 1.2%; AVR+CABG, 1.9%) and new pacemaker implantation (AVR, 4.4%; AVR+CABG, 3.6%). Survival at 1 year was 93.2% for AVR and 89.4% for AVR+CABG. Total stroke rates at 1 year were 1.6% for AVR and 2.0% AVR+CABG. Quality of life assessment indicated that most patients were in New York Heart Association Functional Classification I or II (AVR, 86%; AVR+CABG, 84%) and that they were satisfied with the overall postoperative course (AVR, 88%; AVR+CABG, 87%).

CONCLUSIONS:

Contemporary surgical AVR yields excellent outcomes with low in-hospital mortality, a low overall complication rate, and good 1-year outcome for all risk groups. Accordingly, conventional AVR remains an important therapeutic option for many patients.

[Indexed for MEDLINE]

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