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 machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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 source (direct Gemma or distilled Codex), 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".