Performance of the heart team approach in daily clinical practice in high‐risk patients with aortic stenosis
| Autor: | Isidre Vilacosta, Angela McInerney, David Vivas, Hernán Mejía-Rentería, Pablo Salinas, Nieves Gonzalo, Fernando Macaya, Enrique Villagrán, Carlos Macaya, Jose Alberto de Agustin, Gabriela Tirado-Conte, Luis Nombela-Franco, Iván J. Núñez-Gil, Luis Maroto, Antonio Fernández-Ortiz, Alfonso de Hoyos, Javier Escaned, Pilar Jiménez-Quevedo, Manuel Carnero, Javier Cobiella, Eduardo Pozo, Carolina Espejo-Paeres |
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| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Renal function 030204 cardiovascular system & hematology Transcatheter Aortic Valve Replacement 03 medical and health sciences Therapeutic approach 0302 clinical medicine Aortic valve replacement Risk Factors Internal medicine Heart team Humans Medicine Aged 80 and over Heart Valve Prosthesis Implantation Mitral regurgitation High risk patients business.industry Aortic Valve Stenosis medicine.disease Clinical Practice Stenosis Treatment Outcome 030228 respiratory system Aortic Valve Surgery Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiac Surgery. 36:31-39 |
| ISSN: | 1540-8191 0886-0440 |
| Popis: | OBJECTIVE The heart team (HT) approach plays a key role in selecting the optimal treatment strategy for patients with aortic stenosis (AS). However, little is known about the HT decision process and its impact on outcomes. The aim of this study was to identify the factors associated with the HT decision and evaluate clinical outcomes according to the treatment choice. METHODS The study included a total of 286 consecutive patients with AS referred for discussion in the weekly HT meeting in a cardiovascular institute over 2 years. Patients were stratified according to the selected therapeutic approach: medical treatment (MT), surgical (SAVR), or transcatheter (TAVR) aortic valve replacement. Baseline characteristics involved in making a therapeutic choice were identified and a decision-making tree was built using classification and regression tree methodology. RESULTS Based on HT discussion, 53 patients were assigned to SAVR, 210 to TAVR, and 23 to MT. Older patients (≥88 years old) were mainly assigned to TAVR or MT according to the logistic EuroSCORE ( |
| Databáze: | OpenAIRE |
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