Abstract 19284: Current Results of Surgical Aortic Valve Replacement - Insights from the German Aortic Valve Registry

Introduction: The German Aortic Valve Registry (GARY) has meanwhile included more than 60,000 patients with both surgical (sAVR) and catheter based aortic valve replacement (TAVR). Even though TAVR was a main topic of the last years, sAVR is still the most frequently applied method. The intention of this summary is to deliver a real world all-comers picture of current results of sAVR including combined sAVR and coronary bypass surgery (CABG) in Germany. Methods: All patients included in GARY between 2011 and 2012 who received sAVR alone (13,621 patients, mean age 68.0±11.3 years, mean log. EuroSCORE 8.7%, 39% female) or combined with CABG (7,371 patients, mean age 72.5±7.9 years, mean log. EuroSCORE 10.8%, 28% female) were analysed for in-hospital and one-year outcome. Results: The main indication for surgery was aortic stenosis in 85% and insufficiency in 15%. 16% were operated through a minimally invasive access and 85% received a biological valve prosthesis. For 2011 and 2012, in-hospital mortality was 2.5% (sAVR) and 4.1% (sAVR+CABG), respectively. Other important outcome parameters include cerebrovascular events (sAVR: 2.2%, sAVR+CABG: 3.3%,) and new pacemaker implants (sAVR 3.6%, sAVR+CABG 2.4%,). One year survival was 93.2% for the sAVR and 89.4% for the sAVR+CABG patients. Total stroke rates were low (sAVR 3.0%, sAVR+CABG 4.0%). Most patients were in NYHA class I or II (sAVR 86%, sAVR+CABG 84%) and satisfied with the overall postoperative course (sAVR 88%, sAVR+CABG 87%) Conclusions: Surgical aortic valve replacement resulted in low in-hospital mortality and a low overall complication rate as well as good one-year outcome for all risk groups. These good results should be considered in the current discussion. The detailed combined results of all patients treated from 2011 - 2013 will be ready for presentation at the meeting.