title: Current Results of Surgical Aortic Valve Replacement: Insights From the German Aortic Valve Registry.
abstract: BACKGROUND
  Conventional aortic valve replacement (AVR) remains the therapy of choice for many patients with severe aortic valve disease. The unique German Aortic Valve Registry (GARY) allows the comparison of contemporary outcomes of AVR with those of transcatheter AVRs. We report here real-world, all-comers outcomes of AVR, including combined AVR and coronary bypass grafting (AVR+CABG).
  
  
  METHODS
  A total of 34,063 patients who received AVR (22,107 patients, 39% female; mean age 68.0 ± 11.3 years, mean logistic European System for Cardiac Operative Risk Evaluation, 8.6%) or AVR+CABG (11,956 patients, 28% female; mean age 72.6 ± 7.8 years, mean logistic European System for Cardiac Operative Risk Evaluation, 10.7%) between 2011 and 2013 were analyzed and followed up to assess the 1-year outcome.
  
  
  RESULTS
  In-hospital mortality was 2.3% for AVR and 4.1% for AVR+CABG. Other important outcome variables include stroke (AVR, 1.2%; AVR+CABG, 1.9%) and new pacemaker implantation (AVR, 4.4%; AVR+CABG, 3.6%). Survival at 1 year was 93.2% for AVR and 89.4% for AVR+CABG. Total stroke rates at 1 year were 1.6% for AVR and 2.0% AVR+CABG. Quality of life assessment indicated that most patients were in New York Heart Association Functional Classification I or II (AVR, 86%; AVR+CABG, 84%) and that they were satisfied with the overall postoperative course (AVR, 88%; AVR+CABG, 87%).
  
  
  CONCLUSIONS
  Contemporary surgical AVR yields excellent outcomes with low in-hospital mortality, a low overall complication rate, and good 1-year outcome for all risk groups. Accordingly, conventional AVR remains an important therapeutic option for many patients.
authors.affiliation: Heart Center Leipzig, Germany. Electronic address: dholzhey@web.de.
authors.forename: David
authors.initials: D
authors.lastname: Holzhey
authors.affiliation: Heart Center Leipzig, Germany.
authors.forename: Friedrich W
authors.initials: FW
authors.lastname: Mohr
authors.affiliation: Kerckhoff Heart Center, Bad Nauheim, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Walther
authors.affiliation: Kerckhoff Heart Center, Bad Nauheim, Germany.
authors.forename: Helge
authors.initials: H
authors.lastname: Möllmann
authors.affiliation: Deutsche Gesellschaft für Thorax-, Herz- und Gefäßchirurgie, Berlin, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Beckmann
authors.affiliation: BQS Institute for Quality and Patient Safety, Düsseldorf, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Kötting
authors.affiliation: University Hospital of Jena, Jena, Germany.
authors.forename: Hans Reiner
authors.initials: HR
authors.lastname: Figulla
authors.affiliation: University of Schleswig-Holstein, Kiel, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Cremer
authors.affiliation: Asklepios Klinik St. Georg, Hamburg, Germany.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
authors.affiliation: German Heart Center Munich, Germany.
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Lange
authors.affiliation: Klinikum Schwabing, Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Sack
authors.affiliation: Heart Center Leipzig, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuler
authors.affiliation: Universitätsklinikum Freiburg, Freiburg, Germany.
authors.forename: Friedhelm
authors.initials: F
authors.lastname: Beyersdorf
authors.affiliation: Universitätsklinik des Saarlandes, Homburg/Saar, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Böhm
authors.affiliation: Institut für Pathophysiologie, Universitätsklinikum Essen, Essen, Germany.
authors.forename: Gerd
authors.initials: G
authors.lastname: Heusch
authors.affiliation: Deutsche Herzstiftung; Frankfurt am Main, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Meinertz
authors.affiliation: University of Duisburg-Essen Medical School, Essen, Germany.
authors.forename: Till
authors.initials: T
authors.lastname: Neumann
authors.affiliation: German Cardiac Society, Düsseldorf, Germany.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Papoutsis
authors.affiliation: Institut für Herzinfarktforschung, Ludwigshafen, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Schneider
authors.affiliation: University of Bonn, Bonn, Germany.
authors.forename: Armin
authors.initials: A
authors.lastname: Welz
authors.affiliation: Kerckhoff Heart Center, Bad Nauheim, Germany.
authors.forename: Christian W
authors.initials: CW
authors.lastname: Hamm
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery; D000082882:Bicuspid Aortic Valve Disease; D005260:Female; D005858:Germany; D006330:Heart Defects, Congenital / Q000601:surgery*; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D012042:Registries; D016896:Treatment Outcome