EARLY RESULTS OF TOTALLY ENDOSCOPIC AORTIC VALVE SURGERY IN TAVI-AGE POPULATION

Background and Aim: From EACTS guidelines, TAVI is preferred treatment choice in specific population’s characteristic, age is the major factor in TAVI favour. Study’s aim is to evaluate if Totally Endoscopic Aortic Valve Surgery (EAVS) has satisfactory early results in TAVI-Age population Methods: We performed a retrospective, single-center study of all patients undergone Totally EAVS from April 2014 to August 2024. Inclusion criteria were age > 18 y.o., totally endoscopic approach, AV surgery with or without concomitant procedure. Patient were stratified by age (18 – 74 years, > 75 years). Multivariable regression analysis was used to evaluate early outcomes. Results: 577 patients undergone Totally EAVS, 447 (77.5%) were in the 18-74 years group, 130 (22.5%) in the > 75 years group. Regression analysis was adjusted for confounders. Before adjustment the 18 -74 y.o. population had lower hospitalization stay (medians days) (5 vs 6, p=0.003), all cause mortality (0.5% vs 4.4%, p=0.01), stroke (0.8% vs 4.5%, p=0.045), pacemaker implantation (2.9% vs 9.1%, p=0.01), ICU time (medians, hours) (24 vs 37, p=0.001). After adjustment 30-day mortality (OR 5.38, p=0.17), hospitalizations stay (beta - 0.29, p=0.71), ICU time (beta -0.24, p=0.98) did not differ. Pace-maker implantation (OR 2.66, p=0.08) and stroke (OR 4.86, p=0.06) were close to statistical significance. Conclusions: Totally EAVS in > 75 y.o. population had no difference in ICU time, hospital stay, mortality. A closely significant higher risk of stroke and pace-maker implantation was noted. Totally EAVS in TAVI-Age population has satisfactory early results and could be considered as alternative approach.