{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T18:54:49Z","timestamp":1776106489701,"version":"3.50.1"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,4,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Transfemoral transcatheter aortic valve replacement (TF\u2010TAVR) is recommended for patients suffering from aortic valve stenosis at increased operative risk. Beyond that, patients with different comorbidities could benefit from TF\u2010TAVR. The present study compares real\u2010world in\u2010hospital outcomes of surgical aortic valve replacement and TF\u2010TAVR.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              For all 33\u00a0789 isolated TF\u2010TAVR and surgical aortic valve replacement procedures performed in Germany in 2014 and 2015, comorbidities and in\u2010hospital outcomes were identified by\n              <jats:italic>International Classification of Diseases (ICD)<\/jats:italic>\n              \u2010 and OPS (Operation and procedure key)\u2010codes. Patients undergoing TF\u2010TAVR were older and at increased estimated risk. Outcomes were risk\u2010adjusted to allow comparison. TF\u2010TAVR was associated with a lower risk for acute kidney injuries (odds ratio [OR] 0.62,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), for bleeding (OR 0.17,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and for prolonged mechanical ventilation (&gt;48\u00a0hours, OR 0.21,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Risk for stroke was similar (OR 1.07,\n              <jats:italic>P<\/jats:italic>\n              =0.558). As expected, the risk for pacemaker implantations was higher after TF\u2010TAVR (OR 4.61,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). In all patients, none of the treatment strategies had a clear advantage on the risk for in\u2010hospital mortality (OR 0.83,\n              <jats:italic>P<\/jats:italic>\n              =0.068). However, in patients aged &gt;80\u00a0years and at high operative risk undergoing TF\u2010TAVR in\u2010hospital mortality was lower (TF\u2010TAVR versus surgical aortic valve replacement 80\u201384, OR 0.55;\n              <jats:italic>P<\/jats:italic>\n              =0.002; \u226585 years, OR 0.42,\n              <jats:italic>P<\/jats:italic>\n              =0.006; EuroSCORE (European System for Cardiac Operative Risk Evaluation) &gt;9: OR 0.62,\n              <jats:italic>P<\/jats:italic>\n              =0.001). TF\u2010TAVR was superior in patients with renal failure and in NYHA (New York Heart Association)\u2010Class III\/IV. Other risk groups were not found to be factors favoring a treatment strategy.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The present study indicates a superiority of TF\u2010TAVR in clinical practice for patients at increased operative risk, aged &gt;80\u00a0years, in NYHA\u2010Class III\/IV, and with renal failure.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.011504","type":"journal-article","created":{"date-parts":[[2019,3,22]],"date-time":"2019-03-22T09:00:17Z","timestamp":1553245217000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Risk\u2010Adjusted Comparison of In\u2010Hospital Outcomes of Transcatheter and Surgical Aortic Valve Replacement"],"prefix":"10.1161","volume":"8","author":[{"given":"Peter","family":"Stachon","sequence":"first","affiliation":[{"name":"University Heart Center Freiburg Department of Cardiology and Angiology I Faculty of Medicine University of Freiburg Freiburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus","family":"Kaier","sequence":"additional","affiliation":[{"name":"University Heart Center Freiburg Department of Cardiology and Angiology I Faculty of Medicine University of Freiburg Freiburg Germany"},{"name":"Institute of Medical Biometry and Medical Informatics University Medical Center Freiburg Faculty of Medicine University of Freiburg Freiburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Zirlik","sequence":"additional","affiliation":[{"name":"University Heart Center Freiburg Department of Cardiology and Angiology I Faculty of Medicine University of Freiburg Freiburg Germany"},{"name":"Department of Cardiology University Hospital Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Bothe","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery Heart Center Freiburg Faculty of Medicine University of Freiburg Freiburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timo","family":"Heidt","sequence":"additional","affiliation":[{"name":"University Heart Center Freiburg Department of Cardiology and Angiology I Faculty of Medicine University of Freiburg Freiburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manfred","family":"Zehender","sequence":"additional","affiliation":[{"name":"University Heart Center Freiburg Department of Cardiology and Angiology I Faculty of Medicine University of Freiburg Freiburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Bode","sequence":"additional","affiliation":[{"name":"University Heart Center Freiburg Department of Cardiology and Angiology I Faculty of Medicine University of Freiburg Freiburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constantin","family":"von zur M\u00fchlen","sequence":"additional","affiliation":[{"name":"University Heart Center Freiburg Department of Cardiology and Angiology I Faculty of Medicine University of Freiburg Freiburg 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