2026-04-17T07:47:58Zhttps://recercat.cat/oai/request

oai:recercat.cat:2072/4852642025-08-31T18:18:00Zcom_2072_98col_2072_378192

00925njm 22002777a 4500 dc Lopez-Martinez, Helena author Vilalta, Victoria author Farjat-Pasos, J. author Ferrer-Sistach, Elena author Mohammadi, S. author Escabia, Claudia author Kalavrouziotis, D. author Resta, Helena author Borrellas, Andrea author Dumont, E. author Carrillo, Xavier author Paradis, J.M. author Fernandez-Nofrerias, Eduard author Delgado, Victoria author Rodés-Cabau, J. author Bayés-Genís, Antoni author Universitat Autònoma de Barcelona author 2024 Aims: In low-risk patients with severe aortic stenosis (AS), sutureless surgical aortic valve replacement (SU-SAVR) may be an alternative to transcatheter aortic valve implantation (TAVI). The risk of heart failure hospitalization (HFH) after aortic valve replacement (AVR) in this population is incompletely characterized. This study aims to investigate the incidence, predictors, and outcomes of HFH in patients undergoing SU-SAVR versus TAVI. Methods and results: Patients referred for AVR between 2013 and 2020 at two centres were consecutively included. The decision for SU-SAVR or TAVI was determined by a multidisciplinary Heart Team. Cox regression and competing risk analysis were conducted to assess adverse events. Of 594 patients (mean age 77.5 ± 6.4, 59.8% male), 424 underwent SU-SAVR, while 170 underwent TAVI. Following a mean follow-up of 34.1 ± 23.1 months, HFH occurred in 112 (27.8%) SU-SAVR patients and in 8 (4.8%) TAVI patients (P < 0.001). The SU-SAVR cohort exhibited higher all-cause mortality (138 [32.5%] patients compared with 30 [17.6%] in the TAVI cohort [P < 0.001]). These differences remained significant after sensitivity analyses with 1:1 propensity score matching for baseline variables. SU-SAVR with HFH was associated with increased all-cause mortality (61.6% vs. 23.1%, P < 0.001). Independent associates of HFH in SU-SAVR patients included diabetes, atrial fibrillation, chronic obstructive pulmonary disease, lower glomerular filtration rate and lower left ventricular ejection fraction. SU-SAVR patients with HFH had a 12-month LVEF of 59.4 ± 12.7. Conclusions: In low-risk AS, SU-SAVR is associated with a higher risk of HFH and all-cause mortality compared to TAVI. In patients with severe AS candidate to SU-SAVR or TAVI, TAVI may be the preferred intervention. http://hdl.handle.net/2072/485264 Aortic stenosis cardiomyopathy Aortic valve stenosis Heart failure Mortality Prostheses and implants Heart failure hospitalization following surgical or transcatheter aortic valve implantation in low-risk aortic stenosis