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dc.contributor.advisor Puls, Miriam PD Dr.
dc.contributor.author Viel, Tanja
dc.date.accessioned 2017-08-08T09:36:51Z
dc.date.available 2017-08-15T22:50:07Z
dc.date.issued 2017-08-08
dc.identifier.uri http://hdl.handle.net/11858/00-1735-0000-0023-3EC8-D
dc.language.iso deu de
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.ddc 610 de
dc.title Verhältnis von Nutzen und Risiko der kathetergestützten Aortenklappenimplantation (TAVI) in verschiedenen Subgruppen einer unizentrischen Kohorte mit chirurgischen Hochrisikopatienten de
dc.type doctoralThesis de
dc.title.translated The risk-to-benefit ratio of transcatheter aortic valve implantation in specific patient cohorts in a single-centre with high-risk patients de
dc.contributor.referee Schillinger, Wolfgang Prof. Dr.
dc.date.examination 2017-08-08
dc.description.abstracteng Background: Transcatheter aortic valve implantation (TAVI) has recently developed into an acceptable alternative to conventional surgery in high-risk patients. However, information on the identification of patients gaining most benefit from this procedure is still limited. The aim of this study was to evaluate safety and efficacy of TAVI in different patient cohorts. Methods: Between August 2008 and December 2010, 180 high-risk patients underwent TAVI at our institution (97 transapical and 83 transfemoral approaches). Periprocedural complications as well as mortality and incidence of MACCE during follow-up were recorded. Results: Mean age was 82 ± 5 years, and mean logistic EuroScore 27 ± 14%. In the total cohort, 30-day mortality was 8.9% and 12-month survival (according to Kaplan-Meier-analysis) 72%, with no significant differences between the two approaches. However, a significant difference in survival was obvious after stratification of patients according to logistic EuroScore mortality estimates. Survival proportions at 1 year were 62% in patients with logistic EuroScore >40%, 71% in patients with EuroScore 20-40% and 80% in octogenarians with EuroScore <20% (P = 0.009). Furthermore, the observed median event-free survival as an indicator for morbidity ranged between 315 days in the first, 442 days in the second and 710 days in the third group (P = 0.1). Conclusions: TAVI proved to be feasible with reproducible results. However, mortality and rehospitalization rates were considerably high in specific patient cohorts, suggesting that the risk-to-benefit ratio of TAVI should be validated individually. In the present study, octogenarians with logistic EuroScore <20% could be identified as candidates apparently gaining high benefit from the procedure. de
dc.contributor.coReferee Tirilomis, Theodor Prof. Dr.
dc.contributor.thirdReferee Sigler, Matthias Prof. Dr.
dc.subject.ger TAVI de
dc.subject.ger Hochrisikopatienten de
dc.subject.ger MACCE de
dc.subject.eng TAVI de
dc.subject.eng high-risk patients de
dc.subject.eng MACCE de
dc.identifier.urn urn:nbn:de:gbv:7-11858/00-1735-0000-0023-3EC8-D-3
dc.affiliation.institute Medizinische Fakultät de
dc.subject.gokfull Innere Medizin - Allgemein- und Gesamtdarstellungen (PPN619875747) de
dc.description.embargoed 2017-08-15
dc.identifier.ppn 89520701X

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