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24th Annual Cardiologists Conference

Barcelona, Spain

Alexander Manché

Alexander Manché

Mater Dei Hospital, Malta

Title: Long-term relative survival study after surgical aortic valve replacement in patients with intermediate risk


Biography: Alexander Manché


The indications for Transcatheter Aortic Valve Implantation (TAVI) are evolving. The original indication, in patients with unacceptably high risk for surgery, was expanded to include high-risk patients also eligible for surgery. TAVI is now being offered to intermediate-risk patients without available long-term data. Surgery in these patients offers excellent results, both in the short and long term.
Surgical aortic valve replacement, with or without concomitant coronary revascularisation, can achieve a normal life expectancy in intermediate-risk patients aged 68 or older. We present a 20-year relative survival study, comparing patients’ outcomes with that of normal controls derived from the National Statistics database. The study also correlated long-term survival with patient-related, procedure-related and post-operative complication-related factors.
Surgical AVR for severe aortic stenosis in intermediate-risk patients yields excellent long-term survival. The decision to offer TAVI to these patients should factor in the known long-term results of surgery.

Recent Publications:

  1. Long-term outcomes after surgical aortic valve replacement. A Manché. Cardiothoracic Department, Mater Dei Hospital, Malta. J Clin Exp Cardiolog 2017, 8:9(Suppl): 31. doi: 10.4172/2155-9880-C1-077.
  2. TAVI : Trans-Apical and trans-Aortic approaches.  A Manché. Invited speaker in symposium on The TAVI Experience in Malta. Drugsales Ltd, in conjunction with Edwards Life Sciences. October 2011.
  3. Initial TAVI experience in Malta. A Manché, A Cassar, A Fenech. Oral presentation,  8th Maltese Medical School conference, Malta, November 2012.
  4. Early surgical intervention in aortic valve disease. A Manché. Oral presentation,  5th Annual meeting of the Maltese Cardiac Society, Malta, October 2014.
  5. Should patients with asymptomatic severe aortic stenosis be referred for surgery? A Manché. Oral presentation,  International Congress of Cardiology, Malta, March 2015.
  6. Is valve size more important than patient-prosthesis mismatch in long-term survival after aortic valve replacement?  A Manché, L Camilleri. Malta Medical Journal 2015; 27:Suppl. 95 Abstract P3.06.
  7. Long-term survival after aortic valve replacement: A twenty-year relative survival study. A Manché, L Camilleri, D Gauci. Malta Medical Journal 2015; 27:Suppl. 64 Abstract OP6.18.
  8. Does aortic valve replacement restore normal life expectancy? a twenty-year relative survival study.  A Manché, L Camilleri, D Gauci. International Cardiovascular Forum Journal 2016;6:3-10.
  9. At what age does aortic valve replacement restore life expectancy? A Manché, L Camilleri. SCTS Conference News. The official newspaper of the SCTS Annual Meeting and Cardiothoracic Forum 2016. page 30.
  10. The myths and challenges of patient-prosthesis mismatch. A Manché. Oral presentation 7th Annual meeting of the Maltese Cardiac Society, Malta, October 2016.
  11. The impact of age in prosthesis-patient mismatch on long-term survival after aortic valve replacement: in-vitro versus in-vivo values.  A Manché, A Casha, L Camilleri. Journal of Advances in Medical and Pharmaceutical Sciences 2016;9:1-8   JAMPS.28381 ISSN: 2394-1111.