ArticleEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2023
Choosing transcatheter aortic valve replacement in porcelain aorta: outcomes versus surgical replacement.
Article in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 8 citations in OpenAlex.
- Porcelain Aorta in TAVR: Predictor of Adverse Outcomes or Overestimated Risk Factor?Medicina (Kaunas, Lithuania) · 2026Article
- Transcatheter Aortic Valve Implantation in Low-Risk and Younger Patients with Porcelain Aorta: A State-of-the-Art Narrative Review.Medicina (Kaunas, Lithuania) · 2026Review
- Construction of a Three-Dimensional Calcific Aortic Valve Disease Model Using Human iPSC-Derived Valvular Interstitial Cells.Stem cell reviews and reports · 2026Article
- Review
- Impact of porcelain aorta on outcomes in transfemoral aortic valve implantation (TAVI) with balloon-expandable valves.Open heart · 2025Article
- Transcatheter Aortic Valve Replacement Explant in the Setting of a Porcelain Aorta.JACC. Case reports · 2024Article
- The Predictive Value of Aortic Calcification on Computed Tomography for Major Cardiovascular Events.Journal of clinical medicine · 2024Review
- Risk factors and predictive model for moderate to severe perivalvular leakage following transcatheter aortic valve replacement.American journal of translational research · 2024Article
- Aortic valve assessment by cardiac tomography: application in clinical practice.Archivos peruanos de cardiologia y cirugia cardiovascularReview
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Authors and funding
9 authors at 1 institution in 1 country.
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Abstract
objectivesPorcelain aorta complicates aortic valve replacement and is an indication for transcatheter approaches. No study has compared surgical and transcatheter valve replacement in the setting of porcelain aorta. We characterize porcelain aorta patients undergoing aortic valve replacement and the association of aortic calcification and outcomes.
methodsPatients undergoing aortic valve replacement with porcelain aorta were identified. Aortic calcium volume was determined using 3D computed tomography thresholding techniques. Propensity scoring was performed to assess the effect of surgical versus transcatheter approaches. Risk factors for composite major hospital complications (death, stroke and dialysis) were identified using random forest machine learning.
resultsFrom January 2006 to January 2015, 164 patients with porcelain aorta underwent aortic valve replacement [105 (64%) surgical replacement, 59 (36%) transcatheter replacement]. Propensity scoring matched 29 pairs (49% of transcatheter patients). Before matching, 5-year survival was 41% [(43% surgical, 35% transcatheter, P(log-rank) = 0.9]. After matching, mortality for surgical versus transcatheter replacement was 3.4% (n = 1) vs 10% (n = 3), stroke 14% (n = 4) vs 3.4% (n = 1) and dialysis 6.9% (n = 2) versus 11% (n = 3). Matched 5-year survival was 40% after surgical replacement and 29% after transcatheter replacement [P(log-rank) = 0.4]. Total aortic calcium volume was greater in transcatheter than surgical patients [18 (8.0) vs 17 (7.7) ml] and was associated with more major hospital complications after either approach.
conclusionsSurgical and transcatheter approaches are complementary options for aortic stenosis with porcelain aorta. Surgical valve replacement remains an effective treatment for patients requiring concomitant procedures. Quantifying aortic calcium volume is a helpful risk predictor in all patients with porcelain aorta.
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