Mixed aortic stenosis in patients undergoing TAVI was associated with a higher incidence of postprocedural aortic regurgitation compared to pure aortic stenosis (42.6% vs 26.5%; OR 2.882; P<0.001).
Cohort (n=1,062)
Yes
Does mixed aortic stenosis compared to pure aortic stenosis worsen postprocedural aortic regurgitation and mortality in patients undergoing TAVI?
In patients undergoing TAVI, mixed aortic stenosis increases the risk of postprocedural aortic regurgitation and major bleeding but does not negatively impact long-term survival compared to pure aortic stenosis.
Effect estimate: OR 2.882 (95% CI 1.851-4.488)
Absolute Event Rate: 42.6% vs 26.5%
p-value: p=<0.001
OBJECTIVES: We sought to evaluate the impact of mixed aortic stenosis (MAS) on postprocedural aortic regurgitation (PPAR) and clinical outcomes after transcatheter aortic valve implantation (TAVI). BACKGROUND: The impact of MAS of TAVI outcomes is unknown. METHODS AND RESULTS: Data from a multicenter registry were retrospectively analysed. Outcomes were compared between patients with pure aortic stenosis (PAS; associated AR<1+/3+) and MAS (associated AR≥1+/3+). Study objectives were PPAR incidence and short- and long-term mortality. Overall, 1,062 patients were included: 419 (39.4%) with MAS and 643 (60.5%) with PAS. At 30 days, there were no differences in mortality, however, a higher incidence of major bleeding (22.7% vs. 16.8%; P=0.016), PPAR≥1+/3+ (42.6% vs. 26.5%; P<0.001) and lower device success (89.3% vs. 93.3%; P=0.019) was observed in patients with MAS. Of note, MAS was an independent predictor of PPAR≥1+/3+ at multivariable analysis (OR: 2.882; CI: 1.851-4.488; P<0.001). At 2 years of follow-up, no survival differences were present between MAS and PAS groups. Similarly, following stratification for PPAR≥1+/3+, MAS had no protective effect on survival as compared with PAS. CONCLUSIONS: MAS was associated with lower device success and higher PPAR incidence. However, despite these findings, it had no influence on long-term postoperative outcomes.
Chieffo et al. (Fri,) conducted a cohort in Aortic stenosis undergoing Transcatheter Aortic Valve Implantation (TAVI) (n=1,062). Mixed aortic stenosis (MAS) vs. Pure aortic stenosis (PAS) was evaluated on Postprocedural aortic regurgitation (PPAR) ≥1+/3+ (OR 2.882, 95% CI 1.851-4.488, p=<0.001). Mixed aortic stenosis in patients undergoing TAVI was associated with a higher incidence of postprocedural aortic regurgitation compared to pure aortic stenosis (42.6% vs 26.5%; OR 2.882; P<0.001).