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Comparison of Pre- and Post-Operative Characteristics in Octogenarians Having Isolated Surgical Aortic Valve Replacement Before versus After Introduction of Transcatheter Aortic Valve Implantation
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International audience. Aortic stenosis (AS) is the most frequent heart valve disease. Surgical aortic valve replacement (SAVR) is the reference treatment. Transcatheter aortic valve implantation (TAVI) has emerged as an alternative treatment. New strategies for treating the AS are upcoming. The aim of the study was to assess if the clinical profile of octogenarian patients treated surgically before and after the TAVI program initiation has changed. We retrospectively included consecutive octogenarian patients, who underwent isolated SAVR, between January 2006 and December 2011 in a single high-volume center. We compared preoperative and postoperative characteristics before and after the initiation of TAVI (February 2009). 517 patients were included: 229 in the "before TAVI" group (2006-2008), 288 in the "after TAVI" group (2009-2011). The mean age was 83.2±2.0 in the "before TAVI" group, 83.5 ± 2.1 in the "after TAVI" group (p=0.106). There were no significant differences in preoperative characteristics: NYHA class (p=0.374), history of heart failure (p=0.680), left ventricular ejection fraction (59.8±12.2% in the "before TAVI" group, 59.9±11.3% in the "after TAVI" group, p=0.922), coronary artery disease (p=0.431), chronic pulmonary disease (p=0.363), previous cardiac surgery (p=0.085). The logistic EuroSCORE was 7.78±4.60% in the "before TAVI" group and 7.33±3.96% in the "after TAVI" group (p=0.236). The operative mortality (30-day) was comparable: 5.2% in the "before TAVI" group, 6.9% in the "after TAVI" group (p=0.424). Thus, with the emergence of TAVI, the number of octogenarian patients operated on, their preoperative characteristics and the operative mortality remained comparable.
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