Impact of diverse aortic pathologies on outcomes after transapical transcatheter aortic valve replacement

Autor:	Dritan Useini, Hildegard Christ, Justus Strauch, Blerta Beluli
Rok vydání:	2021
Předmět:	Pulmonary and Respiratory Medicine medicine.medical_specialty Time Factors Transcatheter aortic medicine.medical_treatment 030204 cardiovascular system & hematology Risk Assessment Transcatheter Aortic Valve Replacement 03 medical and health sciences 0302 clinical medicine Valve replacement Risk Factors Internal medicine medicine Humans Adverse effect Stroke Aorta business.industry Aortic Valve Stenosis medicine.disease Confidence interval Treatment Outcome 030228 respiratory system Paravalvular leakage Concomitant Aortic Valve cardiovascular system Cardiology Surgery Cardiology and Cardiovascular Medicine business Leriche Syndrome
Zdroj:	Journal of cardiac surgeryREFERENCES. 36(7)
ISSN:	1540-8191
Popis:	OBJECTIVES Some patients who undergo transcatheter aortic valve replacement (TAVR) have a concomitant diverse aortic pathologies (AP). They are usually considered high-risk candidates for the procedure and require further assessment to determine the best vascular approach. The impact of these AP on TAVR is not well known as the information is scarce. We aimed to evaluate midterm clinical impact of different AP after transapical (TA)-TAVR. METHODS Twenty patients with atherosclerotic/occluding aortic diseases (A/OAD) (porcelain aorta, Leriche Syndrome, penetrating aortic ulcer, and aortic thrombus), 24 patients with aortic morphologic diseases (AMD) (thoracic/abdominal aortic aneurysms, aortic kinking, aortic type B dissection, aortic elongation/tortuosity, and previous aortic intervention), and 11 patients with combined aortic diseases (CAD) underwent TA-TAVR treatment between January 2011 and November 2019 at our center. We conducted up to 5-years clinical follow-up. RESULTS All patients were classified in the heart team as a high interventional risk. The 30-day mortality and stroke were 5% and 10% in the A/OAD, 8.3% and 0% in the AMD, and 0% and 0% in the CAD, respectively. The median time of freedom from a composite of death and cardio-cerebral adverse events was 22.1 months [95% confidence interval [CI]: 9.9-34.3] in A/OAD versus 34.3 months [95% CI: 15.6-53] in AMD versus 17 months [95% CI: 0-39.4] in CAD; p = .525. We registered neither procedural aortic injury nor aortic syndrome at follow-up. The moderate/severe paravalvular leakage rates were 5%, 0% and 0% in the A/OAD, AMD and CAD, respectively. CONCLUSION Independent of underlying AP, the TA-TAVR is a safe method and shows very promising early and midterm outcomes in patients with various AP.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::08168e3112fb82dc95c791410afcd5cd https://pubmed.ncbi.nlm.nih.gov/33783007 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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