0258: Comparison of transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement in very high risk patients, monocentric registry of an early experience

The PARTNER trial has shown that TAVI is not inferior to surgical aortic valve replacement (AVR) in high-risk aortic stenosis. However, real life registry comparing TAVI and surgery are lacking. monocentric registry of high-risk patients (lEUROSCORE1 ≥15%) undergoing TAVI (114 patients) or AVR (81 patients) between 2009 and 2013 in our institution. Mean age was 84,4 and 83,6 yo (p=NS). TAVI patients had higher EUROSCORE1 (31 vs 24.5%, p<0,001), lower LVEF (48,4 vs 57%, p<0,0001) and lower mean aortic gradient (46 vs 53mmHg, p=0,0001). Mortality in-hospital was not statistically different between TAVI and AVR; 9,6 vs 17,3% respectively (p=0,12). TAVI patients presented more vascular complications (11,4 vs 0%, p= 0,001), needed more Pace-Maker (24,6 vs 4,9%, p<0,0001) but presented less in-hospital infections (11 vs 19%, p=0,008), less new atrial fibrillation (20 vs 41%, p=0,002), and needed less transfusions (25,4 vs 80,2%, p<0,0001). The present registry results confirm that TAVI is a real alternative to surgery in patients with at high surgical risk. Longer follow up is required to confirm these results. Abstract 0258 – Table. AVR TAVI p n 81 114 Age 83.6 84.4 0.21 Euroscore1 (%) 24.5 31 <0.0001 FEV (%) 57.1 48.5 <0.0001 DTVG (mm) 51 54 0.086 Mean Gradient (mmHg) 53 46 0.008 Creatinin pre (microM/L) 111 138 0.003 Hemoglobin pre (g/100) 12.6 11.6 <0.0001 Death (%) 17.3 9.6 0.12 Vascular complication (%) 0 11.4 0.001 Infection (%) 19 11 0.008 Dialysis (%) 13.6 11.4 0.65 AFIB post (%) 41 20 0.002 Pericardial effusion (% ) 2.5 8.8 0.13 Stroke (%) 4.9 1.8 0.23 Pace Maker (%) 4.9 24.6 <0.0001 Transfusions (%) 80 25 <0.0001