Why the study?
Does baseline pulmonary hypertension (sPAP ≥ 50 mmHg) increase mortality and complications in patients undergoing TAVR?
Does baseline pulmonary hypertension (sPAP ≥ 50 mmHg) increase mortality and complications in patients undergoing TAVR?
Baseline pulmonary hypertension (sPAP ≥ 50 mmHg) is an independent risk factor for increased 1-year mortality, AV block, AKI, and longer hospital stays following TAVR.
sPAP ≥50 mmHg was associated with higher post-TAVR risks; hypothesis-generating, requires prospective validation before changing practice.
Aortic stenosis (AS) leads to pulmonary hypertension (PH) and right ventricle (RV) failure. Our goal was to describe mortality related to postoperative complications in PH patients undergoing transcatheter aortic valve replacement (TAVR). Ninety-three TAVR patients were analyzed (controls, sPAP < 50 mmHg; cases, sPAP ≥ 50 mmHg). Significant findings in cases included increased mortality (365 days), post-TAVR atrioventricular block (AVB) and acute kidney injury (AKI), and increased mean length of stay (LOS). This novel study highlights complications of PH as independent risk factors for death and significant morbidity post TAVR. Optimization of preoperative volume status and RV afterload reduction, while addressing AVB and AKI, may play a vital role in reducing mortality and LOS.
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Parikh et al. (2017) studied this question.
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