• Gerhard Schymik, Martin Heimeshoff, Peter Bramlage, Tanja Herbinger, Alexander Würth, Lothar Pilz, Jan S Schymik, Rainer Wondraschek, Tim Süselbeck, Jan Gerhardus, Armin Luik, Bernd-Dieter Gonska, Panagiotis Tzamalis, Herbert Posival, Claus Schmitt, and Holger Schröfel.
• 1Medical Clinic IV-Department of Cardiology, Municipal Hospital Karlsruhe, Academic Teaching Hospital of the University of Freiburg, Freiburg, Germany.
• Catheter Cardiovasc Interv. 2015 Oct 1; 86 (4): 738-44.

ObjectivesTo assess outcomes for patients undergoing transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement but with less than high risk.BackgroundWhile there is abundant data for high risk patients there is insufficient data for reduced risk.MethodsPatients undergoing TAVI or SAVR between 2007 and 2012 in Karlsruhe were considered. They were assessed by cardiac computed tomography, transoesophageal echocardiogram, and logistic EuroSCORE I (ES) and groups compared using Propensity Score Matching.ResultsThe mean ES was 10.1±2.8 in the TAVI group (n = 419) and 5.7 ± 3.2 in the SAVR group (n = 722; P < 0.0001). Mean survival probability over 3 years was higher in patients undergoing surgery (P < 0.0001). A total of 432 patients were considered for the matched-pairs analysis based on propensity scores (216 in each group). Major vascular complications (10.6% vs. 0.0%; P < 0.0001), new pacemaker implantation (13.9% vs. 4.6%; P < 0.001) and moderate aortic insufficiency (3.2% vs. 0.5%; P = 0.03) were more frequent in patients undergoing TAVI. Major (20.8% vs. 4.2%; P < 0.0001) and life-threatening (14.5% vs. 2.3%; P < 0.0001) bleeding complications were more frequent in those undergoing surgery. Survival probability over 3 years in the propensity matched cohort was comparable between both groups (P = 0.16).ConclusionsIn this large, single center, real world dataset there was no difference in mortality between patients undergoing TAVI or SAVR during a 3-year follow-up but there was a TAVI related increase in major vascular complications, new pacemaker implantation and aortic insufficiency and a SAVR related increased bleeding risk.© 2015 Wiley Periodicals, Inc.

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