Transcatheter aortic valve implantation in patients with a reduced left ventricular ejection fraction: a single-centre experience in 2000 patients (TAVIK Registry)

Autor: Armin Luik, Panagiotis Tzamalis, Holger Schröfel, Peter Bramlage, Jens Bergmann, Alexander Würth, Lars Oliver Conzelmann, Valentin Herzberger, Gerhard Schymik
Rok vydání: 2017
Předmět:
Male
Aortic valve
medicine.medical_specialty
Time Factors
Population
030204 cardiovascular system & hematology
Severity of Illness Index
Ventricular Function
Left
Transcatheter Aortic Valve Replacement
Ventricular Dysfunction
Left
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
medicine
Humans
Prospective Studies
Registries
030212 general & internal medicine
education
Prospective cohort study
Contraindication
Aged
Aged
80 and over
education.field_of_study
Ejection fraction
business.industry
Aortic Valve Stenosis
General Medicine
Prognosis
medicine.disease
Comorbidity
Stenosis
medicine.anatomical_structure
Aortic Valve
Heart Valve Prosthesis
Aortic valve stenosis
Cardiology
Female
Tomography
X-Ray Computed
Cardiology and Cardiovascular Medicine
business
Echocardiography
Transesophageal
Follow-Up Studies
Zdroj: Clinical Research in Cardiology. 106:1018-1025
ISSN: 1861-0692
1861-0684
Popis: Previous studies into the effect of a reduced left ventricular ejection fraction (EF) on the short- and long-term prognosis of patients undergoing transcatheter aortic valve implantation (TAVI) have reported conflicting findings. We analysed data from the Karlsruhe TAVI registry with the aim of addressing this question.Patients with aortic stenosis undergoing TAVI were divided into sub-groups according to EF: severely reduced (30%; n = 109), reduced (≥30 and ≤40%; n = 201), and mid-range/preserved (40%; n = 1690). VARC complications at 30 days for the population with severely reduced EF did not differ in comparison to the patients with mid-range/preserved EF. Patients with severely reduced EF had a significantly lower survival at 48 h (91.7 vs. 99.0%; p 0.001), at 30 days (84.4 vs. 95.8%; p 0.001) and at 1 year (66.1 vs. 85.0%, p 0.001) compared to those with mid-range/preserved EF. The risk of death increased with age, peripheral arterial disease, poor self-care and chronic renal failure in patients with severely reduced EF.Mortality post-TAVI was higher for patients with a reduced EF, although the excess comorbidity burden likely contributed to this. A reduced EF should not be considered a contraindication for TAVI per se, but the additional presence of comorbidity indicates increased risk for these patients.
Databáze: OpenAIRE
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