@article{Vollenbroich_Sakiri_Roost_Stortecky_Rothenbühler_Räber_Englberger_Wenaweser_Carrel_Windecker_Pilgrim_2019, title={Clinical outcomes in high-risk patients with a severe aortic stenosis: a seven-year follow-up analysis}, volume={149}, url={https://smw.ch/index.php/smw/article/view/2576}, DOI={10.4414/smw.2019.20013}, abstractNote={<p><strong>INTRODUCTION</strong> <p>The aim of this study was to assess the clinical outcomes of high-risk patients with severe aortic stenosis (AS) allocated to medical treatment (MT), transcatheter aortic valve replacement (TAVR), and surgical aortic valve replacement (SAVR) through extended follow-up.</p> <strong>METHODS AND RESULTS</strong> <p>Consecutive patients with severe symptomatic AS included in a prospective single centre registry underwent sweep follow-up between March and August 2016. Clinical outcomes were assessed using a competing risk model. A total of 442 patients (median age 83 years; 52% female) were allocated to MT (n = 78), SAVR (n = 107), or TAVR (n = 257) with a gradient of surgical risk as assessed by logistic EuroSCORE (MT: 27.9 ± 14.5%, TAVR: 24.7 ± 24.9%, SAVR: 12.5 ± 8.2%; p <0.001). Survival after a median duration of follow-up of seven years was 6.4% (MT), 30.4% (TAVR), and 46.7% (SAVR), respectively (p <0.001). One TAVR and one SAVR patient underwent repeat intervention for valvular degeneration between 4.5 and 8.4 years after intervention. Compromised left ventricular function (LVEF <40%) was associated with increased mortality (HR 1.62, 95% CI 1.22–2.15; p <0.0001), whereas female sex was protective (HR 0.68, 95% CI 0.53–0.88; p = 0.0006).</p> <strong>CONCLUSION</strong> <p>Both TAVR and SAVR reduced mortality compared to MT throughout a median duration of follow-up of seven years. Repeat interventions for valvular degeneration were rare.</p></p>}, number={0708}, journal={Swiss Medical Weekly}, author={Vollenbroich, René and Sakiri, Elmaze and Roost, Eva and Stortecky, Stefan and Rothenbühler, Martina and Räber, Lorenz and Englberger, Lars and Wenaweser, Peter and Carrel, Thierry and Windecker, Stephan and Pilgrim, Thomas}, year={2019}, month={Feb.}, pages={w20013} }