Surgical valve selection in the era of transcatheter aortic valve replacement in the Society of Thoracic Surgeons Database
Surgical valve selection in the era of transcatheter aortic valve replacement in the Society of Thoracic Surgeons Database
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DOI：
10.1016/j.jtcvs.2019.05.081
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发表时间：
2020-02-01
影响因子：
6
通讯作者：
Fremes, Stephen E.
中科院分区：
文献类型：
--
作者：
Tam, Derrick Y.;Rocha, Rodolfo V.;Fremes, Stephen E.
目的：在全国代表性数据中，尚未详细探讨经导管主动脉瓣置换术（TAVR）时代外科瓣膜选择的时间趋势。在此，我们使用胸外科医师学会成人心脏手术数据库探索TAVR时代的瓣膜选择趋势。方法：纳入胸外科医师学会成人心脏手术数据库中2004年至2016年的孤立首次生物或机械主动脉瓣置换术（AVR）。以2007年为临界点，检查了TAVR前（2004-2007年）和TAVR后（2008-2016年）的患者特征。使用分段回归分析对时间和所用瓣膜类型之间的关系进行建模，进行变点分析，以经验性地确定总体和特定年龄亚组（60岁）的实践变化时间。结果：2004年至2016年，共有214，390例患者接受了单独的初次机械或生物AVR。患者的平均年龄在两个时期之间略有增加（67.1 vs 68.6岁，P
Objectives: Time trends in surgical valve selection have not been explored in detail in the era of transcatheter aortic valve replacement (TAVR) in nationally representative data. Herein, we explore valve selection trends in the TAVR era using the Society of Thoracic Surgeons Adult Cardiac Surgery Database.Methods: Isolated first-time biological or mechanical aortic valve replacements (AVR) from 2004 to 2016 in the Society of Thoracic Surgeons Adult Cardiac Surgery Database were included. Patient characteristics were examined in the pre-TAVR era (2004-2007) and the post-TAVR era (2008-2016) using the year 2007 as the cut-point. Using a piece-wise regression analysis to model the relationship between time and type of valve used, a change-point analysis was performed to empirically determine the time of change in practice, both overall and in age-specific subgroups (60 years).Results: In total, 214,390 patients underwent isolated primary mechanical or biological AVR from 2004 to 2016. The patients' mean age increased slightly between the 2 eras (67.1 vs 68.6 years, P