Impact of route of access and stenosis subtype on outcome after transcatheter aortic valve replacement.

INTRODUCTION Previous analyses have reported the outcomes of transcatheter aortic valve replacement (TAVR) for patients with low-flow, low-gradient (LFLG) aortic stenosis (AS), without stratifying according to the route of access. Differences in mortality rates among access routes have been established for high-gradient (HG) patients and hypothesized to be even more pronounced in LFLG AS patients. This study aims to compare the outcomes of patients with LFLG or HG AS following transfemoral (TF) or transapical (TA) TAVR. METHODS A total of 910 patients, who underwent either TF or TA TAVR with a median follow-up of 2.22 (IQR: 1.22-4.03) years, were included in this multicenter cohort study. In total, 146 patients (16.04%) suffered from LFLG AS. The patients with HG and LFLG AS were stratified according to the route of access and compared statistically. RESULTS The operative mortality rates of patients with HG and LFLG were found to be comparable following TF access. The operative mortality rate was significantly increased for patients who underwent TA access [odds ratio (OR): 2.91 (1.54-5.48), p = 0.001] and patients with LFLG AS [OR: 2.27 (1.13-4.56), p = 0.02], which could be corroborated in a propensity score-matched subanalysis. The observed increase in the risk of operative mortality demonstrated an additive effect [OR for TA LFLG: 5.45 (2.35-12.62), p < 0.001]. LFLG patients who underwent TA access had significantly higher operative mortality rates (17.78%) compared with TF LFLG (3.96%, p = 0.016) and TA HG patients (6.36%, p = 0.024). CONCLUSIONS HG patients experienced a twofold increase in operative mortality rates following TA compared with TF access, while LFLG patients had a fivefold increase in operative mortality rates. TA TAVR appears suboptimal for patients with LFLG AS. Prospective studies should be conducted to evaluate alternative options in cases where TF is not possible

Camillo Sitte - Gesamtausgabe. Schriften und Projekte

In the Project P16901-G06 sponsored by the FWF, Camillo Sittes writings will be published for the first time in a "critical comprehensive edition", scheduled for six volumes. The basis for this edition is provided by the "Sitte Nachlass-Archiv" owned by the University of Technology, Vienna. The writings of volume four document Sittes writings in the field of pedagogy and school system. Camillo Sitte, who elsewise is predominantly known as urban theorist and urban planner only, earned his money as headmaster of vocational schools (i.e. Gewerbeschulen) and composed number of articles in journals, lectures and treatises. A central part in this volume consists of two lectures held for craftsmen and teachers in ceramics (1883) and cabinetmaking (1885). Those texts give ample evidence of Sitte's didactical methods in the fields of education in applied arts and complement the material provided in volume one about arts and crafts. Sitte combined several shorter articles and reviews with an unpublished paper of principles, the "Grundsätze zur Reform des Zeichenunterrichts", to a kind of draft for a systematics of drawing education. Moreover he takes a stand in a number of articles in newspapers and journals concerning the vocational school system, to whose formation and development he contributed vitally. Wolfgang Sonne and Ruth Hanisch put these texts into context, inform about the current state of research and establish connections to others of Camillo Sitte's fields of activity, which will be documented in the other volumes of this edition. The editorial work is done by Sonja Hnilica and Bernhard Langer. The Editors are Klaus Semsroth, Michael Mönninger and Christiane C. Collins.Im Rahmen des vom FWF finanzierten Projektes P16901-G06 werden erstmals sämtliche Schriften Camillo Sittes in einer auf sechs Bände angelegten "kritischen Gesamtausgabe" herausgegeben. Als Grundlage der Herausgabe dient der Bestand des Sitte Nachlass-Archives, das sich im Eigentum der Technischen Universität Wien befindet. Die Schriften von Band 4 dokumentieren Camillo Sittes Schriften zu Pädagogik und Schulwesen. Camillo Sitte, der vorwiegend als Stadtbautheoretiker und Städtebauer bekannt ist, war im Brotberuf Gewerbeschuldirektor und verfasste in dieser Funktion zahlreiche Fachartikel, Vorträge und Abhandlungen. Einen zentralen Part des Bandes bilden für den Unterricht an der Salzburger Gewerbeschule bestimmte, photomechanisch reproduzierte und bisher unveröffentlichte Skripten zu Themen des Kunstgewerbes und seiner schulischen Vermittlung, die "Vorträge aus dem keramischen Fachlehrer-Curs" (1883) und "Vorträge aus dem Fachlehrer-Curse für Möbelindustrie" (1885). Diese Texte erlauben einen ausführlichen Blick auf Sittes didaktische Methoden im Bereich des Kunstgewerbeunterrichts und ergänzen die in Band 1 wiedergegebenen Texte zum Kunstgewerbe. Eine Reihe kürzerer Artikel und Rezensionen fasste Sitte mit einem bislang unveröffentlichten Grundsatzpapier zu einer Art Vorstudie für eine Systematik des Zeichenunterrichts zusammen. Darüber hinaus bezog er in einer Reihe von Artikeln in Tages- und Fachpresse Stellung zu aktuellen Fragen des gewerblichen Schulwesens in Österreich, an dessen Aufbau er als Schuldirektor der Gewerbeschule zunächst in Salzburg, dann in Wien an entscheidender Stelle mitwirkte. Wolfgang Sonne und Ruth Hanisch stellen die Texte in einen historischen Kontext, geben zum gegenwärtigen Stand der Forschung Auskunft und stellen Verbindungen zu den anderen Wirkungsbereichen Camillo Sittes her, die in den anderen Bänden dokumentiert werden. Die redaktionelle Bearbeitung stammt von Sonja Hnilica und Bernhard Langer. Die Herausgeber der Gesamtausgabe sind Klaus Semsroth, Michael Mönninger und Christiane C. Collins

Camillo Sitte - Gesamtausgabe. Schriften und Projekte

In the Project P16901-G06 sponsored by the FWF, Camillo Sittes writings will be published for the first time in a "critical comprehensive edition", scheduled for six volumes. The basis for this edition is provided by the "Sitte Nachlass-Archiv" owned by the University of Technology, Vienna. The writings of volume four document Sittes writings in the field of pedagogy and school system. Camillo Sitte, who elsewise is predominantly known as urban theorist and urban planner only, earned his money as headmaster of vocational schools (i.e. Gewerbeschulen) and composed number of articles in journals, lectures and treatises. A central part in this volume consists of two lectures held for craftsmen and teachers in ceramics (1883) and cabinetmaking (1885). Those texts give ample evidence of Sitte's didactical methods in the fields of education in applied arts and complement the material provided in volume one about arts and crafts. Sitte combined several shorter articles and reviews with an unpublished paper of principles, the "Grundsätze zur Reform des Zeichenunterrichts", to a kind of draft for a systematics of drawing education. Moreover he takes a stand in a number of articles in newspapers and journals concerning the vocational school system, to whose formation and development he contributed vitally. Wolfgang Sonne and Ruth Hanisch put these texts into context, inform about the current state of research and establish connections to others of Camillo Sitte's fields of activity, which will be documented in the other volumes of this edition. The editorial work is done by Sonja Hnilica and Bernhard Langer. The Editors are Klaus Semsroth, Michael Mönninger and Christiane C. Collins