TY  - BOOK
AU  - Corso, Paul J
AU  - Pichard, Augusto D
TI  - Outcomes in 937 Intermediate-Risk Patients Undergoing Surgical Aortic Valve Replacement in PARTNER 2A
SN  - 0003-4975
PY  - 2018///
KW  - *Aortic Valve Stenosis/su [Surgery]
KW  - *Postoperative Complications/ep [Epidemiology]
KW  - *Transcatheter Aortic Valve Replacement/ae [Adverse Effects]
KW  - Aged
KW  - Aged, 80 and over
KW  - Aortic Valve Stenosis/mo [Mortality]
KW  - Cohort Studies
KW  - Female
KW  - Hospital Mortality
KW  - Humans
KW  - Length of Stay
KW  - Male
KW  - Risk Factors
KW  - Survival Rate
KW  - Treatment Outcome
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007
N2  - BACKGROUND: The PARTNER-2A randomized trial compared outcomes of transfemoral transcatheter (TAVR) and surgical aortic valve replacement (SAVR) in intermediate-risk patients with severe aortic stenosis. The purpose of the current study was to perform an in-depth analysis of outcomes after SAVR in PARTNER-2A; CONCLUSIONS: In this adjudicated prospective study, SAVR in intermediate-risk patients had excellent results at 2 years. However, there were more in-hospital strokes than expected, most likely attributable to mandatory neurologic assessment post-procedure. There was no significant structural valve deterioration during 2-year follow-up. Continued long-term surveillance remains important. Copyright (c) 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved; METHODS: From 1/2012-1/2014, 937 patients underwent SAVR at 57 centers. Mean age was 82+/-6.7 and 55% were men. Less-invasive operations were performed in 140 (15%) and concomitant procedures in 198 (21%). Major outcomes and echocardiograms were adjudicated by an independent events committee. Follow-up was 94% complete to 2 years; RESULTS: Operative mortality was 4.1% (n=38, STS PROM 5.2+/-2.3%), O/E 0.8, and in-hospital stroke 5.4% (n=51), twice expected. Aortic clamp and bypass times were 75+/-30 and 104+/-46 minutes. Patients having severe prosthesis-patient mismatch (n=260, 33%) had similar survival to those without (P>.9), as did those undergoing less-invasive SAVR (P=.3). Risk factors for death included cachexia (P=.004), tricuspid regurgitation (P=.01), coronary artery disease (P=.02), preoperative atrial fibrillation (P=.001), higher white cell count (P<.0001), and lower hemoglobin (P=.0002)
UR  - https://dx.doi.org/10.1016/j.athoracsur.2017.10.062
ER  -