Transcatheter aortic valve implantation in high-risk patients resulted in a 1-year all-cause mortality of 29.9%, which was comparable across different devices and access routes (P=0.295).
Cohort (n=326)
No
Do different TAVI devices and access routes result in comparable mortality and safety outcomes in high-risk surgical patients?
Different TAVI devices and access routes yield comparable 1-year mortality in high-risk patients, with specific perioperative complications strongly predicting adverse outcomes.
p-value: p=0.295
OBJECTIVES: We report the results of a large single-center study evaluating predictors and outcomes after transcatheter aortic valve implantation (TAVI) with different devices and access routes according to the Valve Academic Research Consortium (VARC). BACKGROUND: The widespread adoption of TAVI warrants a systematic analysis of outcomes. Only few comprehensive data exist comparing different approaches as selected by a heart team. METHODS: TAVI was performed in 326 consecutive patients (mean age 80.6 ± 7.1 years, 55.5% female) at high risk for surgery with balloon-expandable and self-expanding devices through transfemoral or transapical access. Data were analyzed according to VARC endpoints; predictors of mortality were identified. RESULTS: All-cause mortality was 10.1% (30 days) and 29.9% (1 year) overall and comparable with regard to valve or access choice (P = 0.295) despite different risk profiles at baseline. Device success and 30-day safety endpoints were achieved in 87.1 and 21.2%. Myocardial infarction hazard ratio (HR) 6.52, stage-2 and -3 acute kidney injury (HR 2.52 and 6.80) and major access site complications (HR 1.96) were independent predictors of 1-year all-cause mortality. Device success had a protective effect (HR 0.58). Baseline predictors included body mass index <20 kg/m(2) (HR 3.20), NYHA class IV (HR 1.87), left ventricular ejection-fraction <30% (HR 2.30), higher STS-PROM scores (HR 1.05 per percent), and age (group 75-85 years, HR 0.47). CONCLUSIONS: Comparable results were achieved with different devices and access routes in a heart team approach. Baseline and perioperative predictors of all-cause mortality were identified, contributing to the refinement of patient and device selection criteria for TAVI.
Seiffert et al. (Wed,) conducted a cohort in High risk for surgery (aortic stenosis) (n=326). Transcatheter aortic valve implantation (TAVI) vs. Different devices and access routes was evaluated on All-cause mortality at 1 year (p=0.295). Transcatheter aortic valve implantation in high-risk patients resulted in a 1-year all-cause mortality of 29.9%, which was comparable across different devices and access routes (P=0.295).