@article{ACS16207,
author = {Sameer A. Hirji and Fernando Ramirez-Del Val and Ahmed A. Kolkailah and Julius I. Ejiofor and Siobhan McGurk and Ritam Chowdhury and Jiyae Lee and Pinak B. Shah and Piotr S. Sobieszczyk and Sary F. Aranki and Marc P. Pelletier and Prem S. Shekar and Tsuyoshi Kaneko},
title = {Outcomes of surgical and transcatheter aortic valve replacement in the octogenarians—surgery still the gold standard?},
journal = {Annals of Cardiothoracic Surgery},
volume = {6},
number = {5},
year = {2017},
keywords = {},
abstract = {Background: Contemporary options for aortic valve replacement (AVR) include transcatheter and surgical approaches (TAVR and SAVR). As evidence accrues for TAVR in high and intermediate risk patients, some clinicians advocate that all patients aged over 80 years should only receive TAVR. Our aim was to investigate the utility of SAVR and minimally invasive AVR (mAVR) among octogenarians in the current era of TAVR.
Methods: From 2002 to 2015, 1,028 octogenarians underwent isolated AVR; 306 TAVR and 722 SAVR, of which 378 patients underwent mAVR. Logistic regression and Cox modeling were used to evaluate overall operative mortality and mid-term survival, respectively. Patients were stratified based on procedural approaches (mAVR or full sternotomy for SAVR, and transfemoral or alternate access for TAVR). Median follow-up was 35 [interquartile range (IQR) 14–65] months.
Results: Compared to SAVR patients, TAVR patients were relatively older (86.2 versus 84.2 years) with co morbidities such as chronic kidney disease (CKD), diabetes mellitus (DM), cerebrovascular disease (CVD), and prior myocardial infarction (MI), all P},
issn = {2304-1021}, url = {https://www.annalscts.com/article/view/16207}
}