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The German Aortic Valve Registry: 1-year results from 13 680 patients with aortic valve disease

Selected in European Journal of Cardio-Thoracic Surgery by Rylski

References

Authors

F. W. Mohr, D. Holzhey, H. Möllmann, A. Beckmann, C. Veit, H. Reiner Figulla, J. Cremer, K.H. Kuck, R. Lange, R. Zahn, S. Sack, G. Schuler, T. Walther, F. Beyersdorf, M. Böhm, G. Heusch, A.K. Funkat, T. Meinertz, T. Neumann, K. Papoutsis, S. Schneider, A. Welz , C. Hamm, for the GARY Executive Board

Reference

Eur J Cardiothorac Surg. 2014 Nov;46(5):808-16

Published

November 2014

Link

Access the abstract

My Comment

Background

The German Aortic Valve Registry (GARY) includes information on a real-world, all comers basis for patients undergoing open conventional or transcatheter aortic valve interventions. There are 78 German centers enrolling data to GARY. A total of 13,860 patients are included since 2011.

Results

  • N=6253 patients underwent conventional aortic valve replacement, whereas n=2497 underwent transcatheter aortic valve implantation (n=1782 via transvascular and n=715 via transapical root). Follow-up at 1 year was known in 98% of patients.
  • The 1-year mortality rate was 6.7% for isolated conventional, 11.0% for conventinal aortic valve replacement with concomitant coronary artery bypass grafting (CABG), 20.7% for transvascular and 28.0% for transapical approach.
  • Stratified into risk groups by means of the EuroSCORE, the highest risk cohorts showed the same mortality at 1 year for different approaches to aortic valve intervention.
  • Over 80% of patients were in the same or better state of health at 1 year after intervention.

My comments

GARY is a national registry including 55% of all aortic valve procedures performed in Germany. The number of included contemporary patients and 1-year quality of life follow-up are the main advantages of this registry. Mohr et al. showed that in the all-comer patient population, conventional surgery in operable patients yields excellent results in all risk groups. The author confirmed that transcatheter aortic valve implantation is a good alternative for high-risk patients.

We can expect now a number of important reports based on GARY. I think that GARY will help to develop new risk models to predict patient outcomes and even to design new valves. It may be also used as a platform for quality improvement in participating institutions.

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