title: Acute and late outcomes of Transcatheter Aortic Valve Implantation (TAVI) for the treatment of severe symptomatic aortic stenosis in patients at high- and low-surgical risk.
abstract: BACKGROUND
  This prospective study examines the impact of EuroSCORE and transfemoral (TF) or transapical (TA) delivery approach on mortality at 30 days and 1 year in patients with severe aortic stenosis implanted with either the Edwards SAPIEN Transcatheter Heart Valve (THV) or Medtronic CoreValve.
  
  
  RESULTS
  TAVI was successfully performed in 293 (97.7%) of 300 patients (TF: 174, TA: 126, mean EuroSCORE 24.0). The mortality at 30 days and after 1 year was 6.0% and 17.3%. Mortality depends significantly on the logistic EuroSCORE with a 30-day odds ratio (OR) of 1.92 (95% CI 1.41 to 2.62, P < 0.001) and after 1 year of 1.67 (95% CI 1.34 to 2.08, P < 0.001). Mortality in patients with a logistic EuroSCORE <15 (n = 113) or ≥15 (n = 187) at 30 days was 0.9% versus 9.1% and after 1 year 7.1% versus 23.5% demonstrating significantly less mortality (P < 0.001) in patients with lower logistic EuroSCOREs. In this specific setup of our center there was no significant difference (P = 0.553) in mortality regarding the technical approach for TA (4.0% and 15.9%) and for TF (7.5% and 18.4%). Severe cardiac complications occurred in 20 patients (6.7%) with a 30-day mortality of 45.0%.
  
  
  CONCLUSIONS
  The mortality in patients undergoing TAVI correlates significantly with the logistic EuroSCORE. Patients with a logistic EuroSCORE <15 can be implanted, with a low 30-day mortality and good long-term outcome over 1 year.
authors.affiliation: Medical Clinic IV, Municipal Hospital Karlsruhe, Germany. G.Schymik@gmx.de
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schymik
authors.forename: Holger
authors.initials: H
authors.lastname: Schröfel
authors.forename: Jan S
authors.initials: JS
authors.lastname: Schymik
authors.forename: Rainer
authors.initials: R
authors.lastname: Wondraschek
authors.forename: Tim
authors.initials: T
authors.lastname: Süselbeck
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Kiefer
authors.forename: Veronika
authors.initials: V
authors.lastname: Balthasar
authors.forename: Armin
authors.initials: A
authors.lastname: Luik
authors.forename: Herbert
authors.initials: H
authors.lastname: Posival
authors.forename: Claus
authors.initials: C
authors.lastname: Schmitt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery*; D006328:Cardiac Catheterization; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome