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Transcatheter or Surgical Aortic Valve Replacement in Patients With Prior Coronary Artery Bypass Grafting.

Publication ,  Journal Article
Conte, JV; Gleason, TG; Resar, JR; Adams, DH; Deeb, GM; Popma, JJ; Hughes, GC; Zorn, GL; Reardon, MJ
Published in: Ann Thorac Surg
January 2016

BACKGROUND: Transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) are treatment options for aortic stenosis in patients with prior coronary artery bypass graft surgery. We assessed the major clinical outcomes of such patients enrolled in the CoreValve High Risk (CHR) study. METHODS: Of the 795 CHR study patients, 226 had prior coronary artery bypass graft surgery; 115 underwent TAVR and 111 underwent SAVR. The primary endpoint was a comparison of all-cause mortality at 1 year. Important secondary clinical endpoints were assessed. RESULTS: At 1 year, all-cause mortality was 9.6% for TAVR versus 18.1% for SAVR (p = 0.06); cardiovascular mortality was 7.0% for TAVR versus 13.8% for SAVR (p = 0.09). A combination of The Society of Thoracic Surgeons risk score greater than 7 and age greater than 80 years was a significant predictor of mortality, with TAVR demonstrating a survival advantage (p = 0.03). No differences were seen for stroke. The SAVR group had longer intensive care unit and hospital stays, increased incidence of acute kidney injury, life-threatening or disabling bleeding, and major adverse cardiac and cerebrovascular events (p < 0.05). Pacemaker implantation and paravalvular regurgitation were greater with TAVR at all timepoints. CONCLUSIONS: For patients with prior coronary artery bypass graft surgery and aortic stenosis, TAVR offers a significant morbidity advantage and a strong trend toward improved survival over SAVR at 1 year.

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Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

January 2016

Volume

101

Issue

1

Start / End Page

72 / 79

Location

Netherlands

Related Subject Headings

  • United States
  • Treatment Outcome
  • Transcatheter Aortic Valve Replacement
  • Survival Rate
  • Severity of Illness Index
  • Respiratory System
  • Postoperative Complications
  • Male
  • Incidence
  • Humans
 

Citation

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Chicago
ICMJE
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Conte, J. V., Gleason, T. G., Resar, J. R., Adams, D. H., Deeb, G. M., Popma, J. J., … Reardon, M. J. (2016). Transcatheter or Surgical Aortic Valve Replacement in Patients With Prior Coronary Artery Bypass Grafting. Ann Thorac Surg, 101(1), 72–79. https://doi.org/10.1016/j.athoracsur.2015.06.067
Conte, John V., Thomas G. Gleason, Jon R. Resar, David H. Adams, G Michael Deeb, Jeffrey J. Popma, G Chad Hughes, George L. Zorn, and Michael J. Reardon. “Transcatheter or Surgical Aortic Valve Replacement in Patients With Prior Coronary Artery Bypass Grafting.Ann Thorac Surg 101, no. 1 (January 2016): 72–79. https://doi.org/10.1016/j.athoracsur.2015.06.067.
Conte JV, Gleason TG, Resar JR, Adams DH, Deeb GM, Popma JJ, et al. Transcatheter or Surgical Aortic Valve Replacement in Patients With Prior Coronary Artery Bypass Grafting. Ann Thorac Surg. 2016 Jan;101(1):72–9.
Conte, John V., et al. “Transcatheter or Surgical Aortic Valve Replacement in Patients With Prior Coronary Artery Bypass Grafting.Ann Thorac Surg, vol. 101, no. 1, Jan. 2016, pp. 72–79. Pubmed, doi:10.1016/j.athoracsur.2015.06.067.
Conte JV, Gleason TG, Resar JR, Adams DH, Deeb GM, Popma JJ, Hughes GC, Zorn GL, Reardon MJ. Transcatheter or Surgical Aortic Valve Replacement in Patients With Prior Coronary Artery Bypass Grafting. Ann Thorac Surg. 2016 Jan;101(1):72–79.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

January 2016

Volume

101

Issue

1

Start / End Page

72 / 79

Location

Netherlands

Related Subject Headings

  • United States
  • Treatment Outcome
  • Transcatheter Aortic Valve Replacement
  • Survival Rate
  • Severity of Illness Index
  • Respiratory System
  • Postoperative Complications
  • Male
  • Incidence
  • Humans