Transcatheter aortic valve replacement for severe aortic stenosis can improve long-term survival of nonagenarians as compared to an age- and sex-matched general population
| Autor: | Martina B. Hautmann, Anno Diegeler, Sebastian Barth, Sebastian Kerber, Karsten Hamm, Wilko Reents, Daniel P. Griese, Michael Zacher |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Transcatheter aortic medicine.medical_treatment Population 030204 cardiovascular system & hematology Transcatheter Aortic Valve Replacement 03 medical and health sciences 0302 clinical medicine Valve replacement Internal medicine medicine Humans 030212 general & internal medicine education Aged 80 and over education.field_of_study business.industry Mortality rate Aortic Valve Stenosis medicine.disease Prognosis Stenosis Aortic valve stenosis Aortic Valve Cohort Cardiology Life expectancy Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of cardiology. 75(2) |
| ISSN: | 1876-4738 |
| Popis: | Background Nonagenarians are at increased risk for morbidity and mortality after transcatheter aortic valve replacement (TAVR) based solely on their age. The aim of our study was to evaluate survival of nonagenarians with severe aortic valve stenosis (AS) after TAVR as compared to an age- and sex-matched general population. Methods From 2009 to 2017, 1052 consecutive patients ≥80 years scheduled for TAVR were included. Patients were divided into three groups depending on their age at the time of the procedure: 80–84 (Group 1), 85–89 (Group 2) and ≥90 years (Group 3). Survival of patients treated with TAVR was compared to the life expectancy of an age- and sex-matched cohort in the general population. Results Nonagenarians were more likely to experience major access-site complications than their younger counterparts (7.6% Group 1 vs. 10.1% Group 2 vs. 17.6% Group 3, p = 0.016). One-year mortality in nonagenarians was higher as compared to the general population (27.8% vs. 20.0%). After two years, the mortality curves between the TAVR patients and the general population converged (39.2% vs. 37.5%) and were lower after five years. Conclusions During the observation period of five years, carefully selected nonagenarians treated with TAVR had at least the same mortality rate as an age- and sex-matched general population after two years despite procedure-associated complications. The negative prognostic impact of the severe AS was completely eliminated by TAVR. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect