Original Research

DOI: 10.4244/EIJ-D-23-00469

Contemporary guideline-directed management of patients with severe aortic valve stenosis

Xi Wang1,2, MD, PhD; Ketina Arslani1, MD; Philippe Nuyens1, MD; Nicholas J. Montarello1, MD; Maarten Vanhaverbeke1, MD, PhD; Gintautas Bieliauskas1, MD; Lars Sondergaard3, MD, DMSc; Ole De Backer1, MD, PhD

Abstract

BACKGROUND: Both surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) are Class Ia recommended therapies for specific subgroups of severe aortic stenosis (AS) patients in the latest 2021 European guidelines.

AIMS: We aimed to report on the multidisciplinary Heart Team evaluation process and real-world practice of treating severe symptomatic AS in East Denmark in the context of the latest European guideline recommendations.

METHODS: All consecutive patients with severe AS referred for intervention in 2021 (N=672) were discussed in a multidisciplinary Heart Team meeting. All patients (100%) had a cardiac computed tomography (CT) analysis prior to the meeting. Baseline characteristics, Heart Team decision-making, final treatment and 30-day clinical outcomes were prospectively recorded.

RESULTS: The majority of severe AS patients (N=456, 68%) were referred for TAVI following discussion in the Heart Team. Ultimately, 94% of patients (N=632) received the Heart Team-recommended treatment. Patients undergoing TAVI (N=439) were significantly older (78.4±6.7 vs 67.2±8.3 years; p<0.001) and more comorbid than patients undergoing SAVR (N=189). The overall 30-day clinical outcomes were satisfactory for both treatment groups (overall 30-day mortality: 1.1%)....

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Volume 20 Number 2
Jan 15, 2024
Volume 20 Number 2
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