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@article{Jahangiri:2021:10.1136/bmjopen-2020-046491,
author = {Jahangiri, M and Bilkhu, R and Embleton-Thirsk, A and Dehbi, H-M and Mani, K and Anderson, J and Avlonitis, V and Baghai, M and Birdi, I and Booth, K and Bose, A and Briffa, N and Buchan, K and Bhudia, S and Cale, A and Deglurkar, I and Farid, S and Hadjinikolaou, L and Jarvis, M and Javadpour, SH and Jeganathan, R and Kuduvalli, M and Lall, K and Mascaro, J and Mehta, D and Ohri, S and Punjabi, P and Venkateswaran, R and Ridley, P and Satur, C and Stoica, S and Trivedi, U and Zaidi, A and Yiu, P and Moorjani, N and Kendall, S and Freemantle, N},
doi = {10.1136/bmjopen-2020-046491},
journal = {BMJ Open},
pages = {1--10},
title = {Surgical aortic valve replacement in the era of transcatheter aortic valve implantation: a review of the UK national database},
url = {http://dx.doi.org/10.1136/bmjopen-2020-046491},
volume = {11},
year = {2021}
}

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TY  - JOUR
AB  - Objectives To date the reported outcomes of surgical aortic valve replacement (SAVR) are mainly in the settings of trials comparing it with evolving transcatheter aortic valve implantation. We set out to examine characteristics and outcomes in people who underwent SAVR reflecting a national cohort and therefore ‘real-world’ practice.Design Retrospective analysis of prospectively collected data of consecutive people who underwent SAVR with or without coronary artery bypass graft (CABG) surgery between April 2013 and March 2018 in the UK. This included elective, urgent and emergency operations. Participants’ demographics, preoperative risk factors, operative data, in-hospital mortality, postoperative complications and effect of the addition of CABG to SAVR were analysed.Setting 27 (90%) tertiary cardiac surgical centres in the UK submitted their data for analysis.Participants 31 277 people with AVR were identified. 19 670 (62.9%) had only SAVR and 11 607 (37.1%) had AVR+CABG.Results In-hospital mortality for isolated SAVR was 1.9% (95% CI 1.6% to 2.1%) and was 2.4% for AVR+CABG. Mortality by age category for SAVR only were: <60 years=2.0%, 60–75 years=1.5%, >75 years=2.2%. For SAVR+CABG these were; 2.2%, 1.8% and 3.1%. For different categories of EuroSCORE, mortality for SAVR in low risk people was 1.3%, in intermediate risk 1% and for high risk 3.9%. 74.3% of the operations were elective, 24% urgent and 1.7% emergency/salvage. The incidences of resternotomy for bleeding and stroke were 3.9% and 1.1%, respectively. Multivariable analyses provided no evidence that concomitant CABG influenced outcome. However, urgency of the operation, poor ventricular function, higher EuroSCORE and longer cross clamp and cardiopulmonary bypass times adversely affected outcomes.Conclusions Surgical SAVR±CABG has low mortality risk and a low level of complications in the UK in people of all ages and risk factors. These results sho
AU  - Jahangiri,M
AU  - Bilkhu,R
AU  - Embleton-Thirsk,A
AU  - Dehbi,H-M
AU  - Mani,K
AU  - Anderson,J
AU  - Avlonitis,V
AU  - Baghai,M
AU  - Birdi,I
AU  - Booth,K
AU  - Bose,A
AU  - Briffa,N
AU  - Buchan,K
AU  - Bhudia,S
AU  - Cale,A
AU  - Deglurkar,I
AU  - Farid,S
AU  - Hadjinikolaou,L
AU  - Jarvis,M
AU  - Javadpour,SH
AU  - Jeganathan,R
AU  - Kuduvalli,M
AU  - Lall,K
AU  - Mascaro,J
AU  - Mehta,D
AU  - Ohri,S
AU  - Punjabi,P
AU  - Venkateswaran,R
AU  - Ridley,P
AU  - Satur,C
AU  - Stoica,S
AU  - Trivedi,U
AU  - Zaidi,A
AU  - Yiu,P
AU  - Moorjani,N
AU  - Kendall,S
AU  - Freemantle,N
DO  - 10.1136/bmjopen-2020-046491
EP  - 10
PY  - 2021///
SN  - 2044-6055
SP  - 1
TI  - Surgical aortic valve replacement in the era of transcatheter aortic valve implantation: a review of the UK national database
T2  - BMJ Open
UR  - http://dx.doi.org/10.1136/bmjopen-2020-046491
UR  - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000713199900010&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
UR  - https://bmjopen.bmj.com/content/11/10/e046491
UR  - http://hdl.handle.net/10044/1/101071
VL  - 11
ER  -

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Mr Prakash P Punjabi

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