The German Aortic Valve Registry (GARY): in-hospital outcome

Eur Heart J. 2014 Jun 21;35(24):1588-98. doi: 10.1093/eurheartj/eht381. Epub 2013 Sep 10.


Background: Aortic stenosis is a frequent valvular disease especially in elderly patients. Catheter-based valve implantation has emerged as a valuable treatment approach for these patients being either at very high risk for conventional surgery or even deemed inoperable. The German Aortic Valve Registry (GARY) provides data on conventional and catheter-based aortic procedures on an all-comers basis.

Methods and results: A total of 13 860 consecutive patients undergoing repair for aortic valve disease [conventional surgery and transvascular (TV) or transapical (TA) catheter-based techniques] have been enrolled in this registry during 2011 and baseline, procedural, and outcome data have been acquired. The registry summarizes the results of 6523 conventional aortic valve replacements without (AVR) and 3464 with concomitant coronary bypass surgery (AVR + CABG) as well as 2695 TV AVI and 1181 TA interventions (TA AVI). Patients undergoing catheter-based techniques were significantly older and had higher risk profiles. The stroke rate was low in all groups with 1.3% (AVR), 1.9% (AVR + CABG), 1.7% (TV AVI), and 2.3% (TA AVI). The in-hospital mortality was 2.1% (AVR) and 4.5% (AVR + CABG) for patients undergoing conventional surgery, and 5.1% (TV AVI) and AVI 7.7% (TA AVI).

Conclusion: The in-hospital outcome results of this registry show that conventional surgery yields excellent results in all risk groups and that catheter-based aortic valve replacements is an alternative to conventional surgery in high risk and elderly patients.

Keywords: Aortic stenosis; Catheter-based valve replacement; GARY; Surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Aortic Valve Stenosis / mortality
  • Aortic Valve Stenosis / surgery*
  • Female
  • Germany / epidemiology
  • Heart Valve Prosthesis / statistics & numerical data
  • Heart Valve Prosthesis Implantation / mortality
  • Heart Valve Prosthesis Implantation / statistics & numerical data*
  • Hospital Mortality
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Patient Selection
  • Prognosis
  • Registries
  • Risk Assessment
  • Transcatheter Aortic Valve Replacement / mortality
  • Transcatheter Aortic Valve Replacement / statistics & numerical data
  • Young Adult