{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"omics_type":["Unknown"],"volume":["17(1)"],"submitter":["Jalava MP"],"funding":["The Finnish Cultural Foundation","The Department of Clinical Medicine, University of Turku","The Finnish Foundation for Cardiovascular Research"],"pubmed_abstract":["<h4>Background</h4>Patients with severe aortic stenosis and left ventricular systolic dysfunction have a poor prognosis, and this may result in inferior survival also after aortic valve replacement. The outcomes of transcatheter and surgical aortic valve replacement were investigated in this comparative analysis.<h4>Methods</h4>The retrospective nationwide FinnValve registry included data on patients who underwent transcatheter or surgical aortic valve replacement with a bioprosthesis for severe aortic stenosis. Propensity score matching was performed to adjust the outcomes for baseline covariates of patients with reduced (≤ 50%) left ventricular ejection fraction.<h4>Results</h4>Within the unselected, consecutive 6463 patients included in the registry, the prevalence of reduced ejection fraction was 20.8% (876 patients) in the surgical cohort and 27.7% (452 patients) in the transcatheter cohort. Reduced left ventricular ejection fraction was associated with decreased survival (adjusted hazards ratio 1.215, 95%CI 1.067-1.385) after a mean follow-up of 3.6 years. Among 255 propensity score matched pairs, 30-day mortality was 3.1% after transcatheter and 7.8% after surgical intervention (p = 0.038). One-year and 4-year survival were 87.5% and 65.9% after transcatheter intervention and 83.9% and 69.6% after surgical intervention (restricted mean survival time ratio, 1.002, 95%CI 0.929-1.080, p = 0.964), respectively.<h4>Conclusions</h4>Reduced left ventricular ejection fraction was associated with increased morbidity and mortality after surgical and transcatheter aortic valve replacement. Thirty-day mortality was higher after surgery, but intermediate-term survival was comparable to transcatheter intervention. Trial registration The FinnValve registry ClinicalTrials.gov Identifier: NCT03385915."],"journal":["Journal of cardiothoracic surgery"],"pagination":["322"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC9759878"],"repository":["biostudies-literature"],"pubmed_title":["Transcatheter and surgical aortic valve replacement in patients with left ventricular dysfunction."],"pmcid":["PMC9759878"],"pubmed_authors":["Jalava MP","Dahlbacka S","Makikallio T","Virtanen M","Laine M","Valtola A","Rosato S","Anttila V","Niemela M","Airaksinen J","Maaranen P","Savontaus M","Raivio P","Kinnunen E","Ahvenvaara T","Husso A","Biancari F","Eskola M","D'Errigo P","Laakso T","Tauriainen T","Jaakkola J","Juvonen T"],"additional_accession":[]},"is_claimable":false,"name":"Transcatheter and surgical aortic valve replacement in patients with left ventricular dysfunction.","description":"<h4>Background</h4>Patients with severe aortic stenosis and left ventricular systolic dysfunction have a poor prognosis, and this may result in inferior survival also after aortic valve replacement. The outcomes of transcatheter and surgical aortic valve replacement were investigated in this comparative analysis.<h4>Methods</h4>The retrospective nationwide FinnValve registry included data on patients who underwent transcatheter or surgical aortic valve replacement with a bioprosthesis for severe aortic stenosis. Propensity score matching was performed to adjust the outcomes for baseline covariates of patients with reduced (≤ 50%) left ventricular ejection fraction.<h4>Results</h4>Within the unselected, consecutive 6463 patients included in the registry, the prevalence of reduced ejection fraction was 20.8% (876 patients) in the surgical cohort and 27.7% (452 patients) in the transcatheter cohort. Reduced left ventricular ejection fraction was associated with decreased survival (adjusted hazards ratio 1.215, 95%CI 1.067-1.385) after a mean follow-up of 3.6 years. Among 255 propensity score matched pairs, 30-day mortality was 3.1% after transcatheter and 7.8% after surgical intervention (p = 0.038). One-year and 4-year survival were 87.5% and 65.9% after transcatheter intervention and 83.9% and 69.6% after surgical intervention (restricted mean survival time ratio, 1.002, 95%CI 0.929-1.080, p = 0.964), respectively.<h4>Conclusions</h4>Reduced left ventricular ejection fraction was associated with increased morbidity and mortality after surgical and transcatheter aortic valve replacement. Thirty-day mortality was higher after surgery, but intermediate-term survival was comparable to transcatheter intervention. Trial registration The FinnValve registry ClinicalTrials.gov Identifier: NCT03385915.","dates":{"release":"2022-01-01T00:00:00Z","publication":"2022 Dec","modification":"2026-05-28T21:27:06.611Z","creation":"2025-02-19T01:55:34.972Z"},"accession":"S-EPMC9759878","cross_references":{"pubmed":["36529781"],"doi":["10.1186/s13019-022-02061-9"]}}