Acute Heart Failure at the Time of Transcatheter Aortic Valve Replacement Does not Increase Mortality
| Autor: | Kendra J. Grubb, Michael P. Flaherty, William T. Burke, Jaimin R. Trivedi |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Transcatheter aortic medicine.drug_class medicine.medical_treatment Treatment outcome 030204 cardiovascular system & hematology Transcatheter Aortic Valve Replacement 03 medical and health sciences Postoperative Complications 0302 clinical medicine Text mining Valve replacement Risk Factors Internal medicine Natriuretic Peptide Brain medicine Natriuretic peptide Humans 030212 general & internal medicine Mortality Aged Retrospective Studies Aged 80 and over Heart Failure business.industry Retrospective cohort study Aortic Valve Stenosis General Medicine Length of Stay medicine.disease Patient Discharge Peptide Fragments Intensive Care Units Treatment Outcome Aortic Valve Heart failure Preoperative Period Aortic valve surgery Cardiology Female Surgery business Cardiology and Cardiovascular Medicine Biomarkers |
| Zdroj: | Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. 13:47-50 |
| ISSN: | 1559-0879 1556-9845 |
| Popis: | Objective Patients presenting for transcatheter aortic valve replacement are often in acute on chronic heart failure, as indicated by elevated N-terminal pro-B-type natriuretic peptide. Many believe that elevated N-terminal pro-B-type natriuretic peptide is an indication to treat medically, reserving surgery until the patient is medically optimized. Methods A single-center transcatheter aortic valve replacement database was queried from December 2015 to November 2016 to identify patients undergoing transcatheter aortic valve replacement. Patients were divided into two cohorts based on preoperative N-terminal pro-B-type natriuretic peptide level. An analysis was then completed to assess outcomes such as length of intensive care unit stay, total length of stay, discharge to home, major complications, and mortality at 30 days. Results There were 142 patients (median age = 80 years, 44% female) with preoperative N-terminal pro-B-type natriuretic peptide data included (range = 106–73,500 pg/mL). The mean Society of Thoracic Surgeons predicative risk of mortality was 8%, and 46 patients (32%) had N-terminal pro-B-type natriuretic peptide of greater than 3000 pg/mL. N-terminal pro-B-type natriuretic peptide of greater than 3000 pg/mL was associated only with increased intensive care unit length of stay of greater than 24 hours (35% vs 9%, P = 0.0001). There was no statistical difference between cohorts with regard to total length of stay of greater than 3 days (24% vs 15%, P = 0.2), discharge to home (74% vs 83%, P = 0.3), major complication, or mortality at 30 days. Conclusions Transcatheter aortic valve replacement is an appropriate and effective treatment for patients with aortic stenosis presenting with high N-terminal pro-B-type natriuretic peptide and acute on chronic heart failure. |
| Databáze: | OpenAIRE |
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