Abstract
Introduction: Other aortic interventions are often compared to surgical aortic valve replacement (SAVR), which is the current gold standard1. In view of the increasing interest in transcatheter aortic valve replacement (TAVR), in our study we analysed the relevance of surgical AVR
Materials and Methods: We analysed 108 consecutive patients who underwent SAVR in a year at our institute in terms of demography, indications, surgical approach and complications. We searched the available literature for comparative studies between surgical and catheter based aortic valve replacement and the outcomes using the MeSH terms aortic valve replacement, TAVI, TAVR.
Results: Surgical AVR continues to be the gold standard in the management of aortic valve disease. TAVR is not entirely risk-free and has high incidence of paravalvular leak, risk of pacemaker implantation and vascular complications.
Conclusions: In low, intermediate as well as high-risk patients surgical AVR continue to be the gold standard of treatment.
Keywords: AVR, TAVI, TAVR, surgical AVR, MICS AVR.
References
- Brown JM, O'Brien SM, Wu C, et al.: Isolated aortic valve replacement in North America comprising 108,687 patients in 10 years: changes in risks, valve types, and outcomes in the Society of Thoracic Surgeons National Database. J Thorac Cardiovasc Surg. 2009; 137(1): 82–90
- Spadaccio C, Alkhamees K and Al-Attar N. Recent advances in aortic valve replacement [version 1; peer review: 2 approved]. F1000Research 2019, 8(F1000 Faculty Rev):1159
(https://doi.org/10.12688/f1000research.17995.1)
- Fischlein T, Meuris B, Hakim-Meibodi K, et al.: The sutureless aortic valve at 1 year: A large multicenter cohort study. J Thorac Cardiovasc Surg. 2016; 151(6): 1617–1626.e4. PubMed Abstract | Publisher Full Text | F1000 Recommendation
- Leon MB, Smith CR, Mack MJ, et al.: Transcatheter or Surgical Aortic-Valve Replacement in Intermediate-Risk Patients. N Engl J Med. 2016; 374(17): 1609–20. PubMed Abstract | Publisher Full Text | F1000 Recommendation
- Pibarot P, Dumesnil JG: Prosthetic heart valves: selection of the optimal prosthesis and long-term management. Circulation. 2009; 119(7): 1034–48.
- Cribier A, Eltchaninoff H, Bash A, et al.: Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation. 2002; 106(24): 3006–8.
- Okamura, Homare & Yamaguchi, Atsushi & Tanaka, Masashi & Naito, Kazuhiro & Kimura, Naoyuki & Kimura, Chieri & Kobinata, Toshiyuki & Ino, Takashi & Adachi, Hideo. (2009). The 17-mm St. Jude Medical Regent Valve Is a Valid Option for Patients With a Small Aortic Annulus. The Annals of thoracic surgery. 87. 90-4. 10.1016/j.athoracsur.2008.09.051.
- Gupta, Dr. (2019). Posterior Aortic Root Enlargement for Small Aortic Root: Early Results. Journal of Medical Science And clinical Research. 7. 10.18535/jmscr/v7i5.91.
- Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, Iung B, Lancellotti P, Lansac E, Rodriguez Muñoz D, Rosenhek R, Sjögren J, Tornos Mas P, Vahanian A, Walther T, Wendler O, Windecker S, Zamorano JL; ESC Scientific Document Group. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2017 Sep 21;38(36):2739-2791
- Reardon MJ, Van Mieghem NM, Popma JJ, et al.: Surgical or Transcatheter Aortic-Valve Replacement in Intermediate-Risk Patients. N Engl J Med. 2017; 376(14): 1321–31
- Jones D, Tchétché D, Forrest J, et al.: The SURTAVI study: TAVI for patients with intermediate risk. EuroIntervention. 2017; 13(5): e617–e620
- Mack MJ, Leon MB, Thourani VH, et al.: Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients. N Engl J Med. 2019; 380(18): 1695–705
- Jones D, Tchétché D, Forrest J, et al.: The SURTAVI study: TAVI for patients with intermediate risk. Euro Intervention. 2017; 13(5): e617–e620
- Tsigkas, Grigorios & Stefanos, Despotopoulos & Athanasios, Makris & Koniari, Ioanna & Stylianos, Armylagos & Periklis, Davlouros & Hahalis, George. (2018). Transcatheter versus surgical aortic valve replacement in severe, symptomatic aortic stenosis. Journal of Geriatric Cardiology: JGC. 15. 76-85. 10.11909/j.issn.1671-5411.2018.01.002.
Corresponding Author
Dr Aabha Divya
Department of Cardiothoracic and Vascular Surgery, Super Speciality Block, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi 110070