TAVI in patients with estimated low or intermediate surgical risk resulted in lower 1-year all-cause mortality (10.1% and 16.1%, respectively) compared to high-risk patients (34.5%, P=0.0003).
Cohort (n=389)
Absolute Event Rate: 16.1% vs 34.5%
p-value: p=0.0003
AIMS: Transcatheter aortic valve implantation (TAVI) is an established treatment alternative to surgical aortic valve replacement in high-risk and inoperable patients and outcomes among patients with estimated low or intermediate risk remain to be determined. The aim of this study was to assess clinical outcomes among patients with estimated low or intermediate surgical risk undergoing TAVI. METHODS AND RESULTS: Between August 2007 and October 2011, 389 consecutive patients underwent TAVI and were categorized according to the Society of Thoracic Surgeons (STS) score into low (STS 8%; n = 94, 24.2%) groups for the purpose of this study. Significant differences were found between the groups (low risk vs. intermediate risk vs. high risk) for age (78.2 ± 6.7 vs. 82.7 ± 5.7 vs. 83.7 ± 4.9, P < 0.001), body mass index (28.1 ± 6.1 vs. 26.5 ± 4.9 vs. 24.4 ± 4.6, P < 0.001), chronic renal failure (34 vs. 67 vs. 90%, P < 0.001), all-cause mortality at 30 days (2.4 vs. 3.9 vs. 14.9%, P = 0.001), and all-cause mortality at 1 year (10.1 vs. 16.1 vs. 34.5%, P = 0.0003). No differences were observed with regards to cerebrovascular accidents and myocardial infarction during 1-year follow-up. CONCLUSION: In contemporary practice, TAVI is not limited to inoperable or STS-defined high-risk patients and should be guided by the decision of an interdisciplinary Heart Team. Compared with patients at calculated high risk, well-selected patients with STS-defined intermediate or low risk appear to have favourable clinical outcomes.
Wenaweser et al. (Wed,) conducted a cohort in Aortic valve disease requiring TAVI (n=389). Transcatheter aortic valve implantation (TAVI) vs. High-risk patients (STS > 8%) was evaluated on All-cause mortality at 1 year (p=0.0003). TAVI in patients with estimated low or intermediate surgical risk resulted in lower 1-year all-cause mortality (10.1% and 16.1%, respectively) compared to high-risk patients (34.5%, P=0.0003).