145 * NO DIFFERENCE IN OUTCOME AT FIVE YEARS AFTER TRANSFEMORAL AND TRANSAPICAL TRANSCATHETER AORTIC VALVE IMPLANTATION IN MORE THAN 1000 PATIENTS
Bibliographic record
Abstract
Objectives: Although the first human transcatheter aortic valve implantation (TAVI) was performed more than 10 years ago, long-term comparative data for different TAVI procedures on larger populations are sparse. We present 5-year follow-up data of a single centre in more than 1000 patients with multiple TAVI techniques. Methods: Since 2007, 1086 consecutive patients (mean age 79.8 ± 7.2 years) have undergone TAVI in a cardiovascular surgery department by an interdisciplinary team. Multiple devices (Medtronic CoreValve, n = 617; Edwards Sapien, n = 342; JenaValve, n = 54; Medtronic Engager, n = 30; Symetis, n = 22; Boston Scientific Lotus, n = 14; St. Jude Portico, n = 1; no valve implanted, n = 6) and access routes (transfemoral, n = 600; transapical, n = 375; subclavian, n = 54; transaortic, n = 48; other, n = 9) have been used. Demographic, clinical and echocardiographic data are prospectively collected in a dedicated database. Results: There was no significant difference in survival with either access route (Kaplan–Meier estimate/log-rank test, P = 0.081, Fig. 1), although logistic EuroSCORE was significantly lower in the transfemoral patients (17.4 ± 11.7% vs 20.4 ± 14.1% in transapical patients, P = 0.01). Five years following the procedure, survival was 45.1% after transfemoral TAVI, and 30.7% after transapical TAVI. Freedom from stroke after 1 and 5 years was 93.9% and 88.4% after transfemoral TAVI and 94.5% and 89.9% after transapical TAVI (P = 0.137). Mean transvalvular aortic gradients, effective orifice areas and regurgitation rates remained unchanged for up to 5 years of echocardiographic follow-up. Sixty-eight percent of the survivors were in NYHA class I or II after 5 years. Conclusion: TAVI shows durable results for up to 5 years. In the long-term, there is no significant difference between clinical and echocardiographic results after transapical or transfemoral procedures.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".