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After correcting for propensity score, differences amongst the three groups were no longer statistically significant (Table?1, last column). According to the inclusion site, 676 patients (73%) were recruited in centres with a cardiac surgery department and catheterization laboratory, 68 (7%) in centres with a catheterization laboratory only and 184 (20%) in hospitals with neither. TAVI was almost completely confined to tertiary centres with a cardiac surgery department (98%). The main reason against indicating AVR in 684 patients was high surgical risk (322, 47.1%), other medical motives (193, 28.2%), patient refusal (134, 19.6%) and family refusal in the case of incompetent http://www.selleck.cn/products/AZD6244.html patients (35, 5.1%). Table?2 shows variables associated with a planned AVR or TAVI versus medical treatment. Katz index and maximum aortic-valve gradient were the only variables associated with both interventions. These variables were also independently associated with a planned treatment other than AVR: Katz index [odds ratio (OR) per category, 1.5; 95% CI 1.3�C1.7], low http://www.selleckchem.com/products/lee011.html maximum gradient (OR per 1?mmHg, 0.99; 95% CI 0.98�C0.99). Other variables associated with an intended strategy other than AVR were age (OR per year, 1.3; 95% CI 1.2�C1.4), EuroSCORE (OR per 1%, 1.02; 95% CI 1.01�C1.04) and presence of systolic dysfunction (OR, 2.0; 95% CI 1.1�C3.7). Systolic pulmonary artery pressure was estimated in 406 patients (43.8%) and also proved to be associated with a planned treatment other than AVR (OR per 1?mmHg, 1.03; 95% CI 1.01�C1.05). Follow-up was performed in 2011 and ranged from 11.2 to 38.9?months (mean 15.6?��?9.4?months, 20.1?��?7.5?months in survivors). Only 3 patients (0.3%) were lost to follow-up. Overall, 357 patients (38.5%) died during the follow-up period: 226 (53.4%) in the planned conservative treatment group, 81 (31.0%) in the planned TAVI group and 50 (20.5%) in the planned AVR group. Survival rates at 6, 12, 18 and 24?months were 81.8%, 72.6%, 64.1% and 57.3%, respectively. The flow of patients after the selected strategy and their mortality rate during follow-up is detailed in Fig.?1. Cross-over was frequent: AVR was performed in only 66.8% of patients intended http://www.selleckchem.com/products/bmn-673.html for this strategy and TAVI in 72.8%. In all types of management, mortality was lower in octogenarians initially selected for AVR, and similar to those initially selected for medical treatment or TAVI (Fig.?1). The mean time from treatment decision to AVR was 4.8?��?4.6?months and to TAVI 2.1?��?3.2?months (P?