WANG Zhihua 1 , ZHAO Zeyuan 1 , HU Junlong 1 , SONG Yaojue 1 , CUI Chenyi 1 , LI Jiahui 1 , LI Jianchao 2 , CHENG Zhaoyun 1
  • 1. Department of Cardiac Surgery, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, 451464, P. R. China;
  • 2. Department of Extracorporeal Circulation, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, 451464, P. R. China;
CHENG Zhaoyun, Email: Chengzhy@zzu.edu.cn
Transcatheter aortic valve replacement; percutaneous coronary intervention; surgical aortic valve replacement; coronary artery disease; coronary artery bypass grafting
10.7507/1007-4848.202311055
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Objective  To compare and analyze the early- to mid-term outcomes of transcatheter aortic valve replacement (TAVR) combined with percutaneous coronary intervention (PCI) versus surgical aortic valve replacement (SAVR) combined with coronary artery bypass grafting (CABG) for the treatment of significant aortic stenosis (AS) and coronary artery disease (CAD). Methods  The data of patients with significant AS and CAD who underwent surgical treatment at Central China Fuwai Hospital of Zhengzhou University from January 2018 to July 2023 were collected. These patients were divided into a TAVR+PCI group and a SAVR+CABG group according to the operation method. Propensity score matching (PSM) was used to select patients with close clinical baseline characteristics, and the early- to mid-term outcomes of the two groups were compared. Results  A total of 272 patients were enrolled, including 208 males and 64 females, with a mean age of 64.16±8.24 years. There were 47 patients in the TAVR+PCI group and 225 patients in the SAVR+CABG group. After 1∶1 PSM, 32 pairs were selected. There was no statistical difference in baseline data between the two groups (P>0.05). Compared with the SAVR+CABG group, the TAVR+PCI group had significantly shorter operative time, mechanical ventilation time, ICU stay, postoperative hospital stay, and less intraoperative bleeding, and significantly lower postoperative transfusion and complete revascularization rates (P<0.05). The differences in the rates of postoperative in-hospital death, myocardial infarction, stroke, and other complications between the two groups were not statistically significant (P>0.05), and the differences in the rates of severe perivalvular leakage, death, or readmission in the mid-term follow-up were not statistically significant (P>0.05). Conclusion  In patients with significant AS and CAD, the early- and mid-term rates of death and complications were similar between those treated with TAVR+PCI and SAVR+CABG, and TAVR+PCI is a safe alternative to SAVR+CABG.