Outcomes of Transcatheter Aortic Valve Implantation in Patients With Low Versus Intermediate to High Surgical Risk
| Autor: | Amit Segev, Ran Kornowski, Arie Steinvil, Paul Fefer, Samuel Bazan, Shmuel Banai, Elad Maor, Abid Assali, Israel M. Barbash, Ariel Finkelstein, Amir Halkin, Haim D. Danenberg, Katia Orvin, David Planner, Hana Vaknin Assa, Zach Rozenbaum |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Transcatheter aortic Referral Population 030204 cardiovascular system & hematology Risk Assessment Transcatheter Aortic Valve Replacement 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Internal medicine medicine Humans In patient Registries 030212 general & internal medicine Israel education Aged Retrospective Studies Aged 80 and over education.field_of_study business.industry Retrospective cohort study Aortic Valve Stenosis Surgery Clinical trial Treatment Outcome Cardiothoracic surgery Cardiology Female Cardiology and Cardiovascular Medicine Risk assessment business |
| Zdroj: | The American Journal of Cardiology. 123:644-649 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/j.amjcard.2018.11.010 |
| Popis: | Referral of low surgical risk (LSR) patients for transcatheter aortic valve implantation (TAVI) becomes common in multiple tertiary centers, and clinical trial data for this population are not available to date. We performed a retrospective analysis on an Israeli multicenter registry. LSR and intermediate-high surgical risk (I-HSR) were defined by a Society of Thoracic Surgery score of4% and ≥4%, respectively. The cohort included 2336 patients (LSR n = 1198, I-HLR n = 1138). As compared with LSR, patients with I-HSR were older and had significantly higher rates of baseline comorbidities. Although devices success rates (94% vs 96%), paravalvular leak (3.5% vs 5.2%), and permanent pacemaker implantation (17.2 vs 18%) were comparable (p0.05 for all comparisons), the safety outcome at 1 month (12.7% vs 9.8%), procedural mortality (1.9% vs 0.6%), and mortality at 3 years (30.1% vs 16.1%) were higher in patients with I-HSR (p0.05 for all comparisons). In a subanalysis of patients with very LSR, comparable rates of device success and safety outcomes were observed, whereas mortality at 1 to 3 years was lower. In conclusion, although procedural outcomes were comparable between LSR and I-HSR TAVI patients, the rates of short- and long-term mortality, as well as the safety outcome, were lower in LSR patients. |
| Databáze: | OpenAIRE |
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