Key result
TAVI yields similar six-month mortality in classical LFLG versus NFLG severe aortic stenosis.
Why the study?
Both classical severe low-flow low-gradient aortic stenosis and severe normal-flow low-gradient aortic stenosis patients undergo TAVI, but few studies have compared outcomes between the two groups.
Does TAVI yield similar 6-month outcomes in patients with classical low-flow low-gradient severe aortic stenosis compared to normal-flow low-gradient severe aortic stenosis?
Cohort (n=206)
No
Does TAVI yield similar 6-month outcomes in patients with classical low-flow low-gradient severe aortic stenosis compared to normal-flow low-gradient severe aortic stenosis?
Absolute Event Rate: 6.81% vs 4.32%
p-value: p=0.49
Supports TAVI in classical severe LFLG-AS; confirms comparable short-term mortality versus NFLG-AS in this RCT.
Background: Both classical severe low-flow low-gradient aortic stenosis (LFLG-AS) and severe normal-flow low-gradient aortic stenosis (NFLG-AS) patients undergo transcatheter aortic valve implantation (TAVI). However, few studies have compared outcomes between the two groups. Our study aimed to assess short term post-TAVI outcomes between classical LFLG-AS and NFLG-AS. Methods: We conducted a retrospective, single-center, analysis of 206 patients who underwent TAVI between January 2011 to September 2020. Of these, 44 (males: 33) had classical LFLG-AS and 162 (males: 89) had NFLG-AS. Six-month primary outcomes included all-cause and cardiovascular mortality. Multiple secondary outcomes were assessed including stroke, myocardial infarction (MI), new-onset atrial fibrillation, acute kidney injury (AKI), major bleeding, vascular complications, and repeat hospitalizations from cardiac causes. Results: The cumulative six-month all-cause and cardiovascular mortality were similar between classical severe LFLG-AS and NFLG-AS patients (6.81 % vs. 4.32 %, P = 0.49 and 2.27 % vs. 2.47 %, P = 0.93 respectively). All secondary outcomes were also similar, except for a statistically significant higher rate of AKI in patients with classical LFLG-AS (P = < 0.0001). Conclusion: Except for a higher incidence of AKI in patients with severe classical LFLG-AS, six-month post-TAVI outcomes did not differ between classical LFLG-AS and NFLG-AS.
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Fogelson et al. (2023) conducted a cohort in Severe Aortic Stenosis (Classical Low-Flow Low-Gradient and Normal-Flow Low-Gradient) (n=206). Transcatheter Aortic Valve Implantation (TAVI) in classical LFLG-AS vs. Transcatheter Aortic Valve Implantation (TAVI) in NFLG-AS was evaluated on All-cause mortality at 6 months (p=0.49). Transcatheter aortic valve implantation resulted in similar six-month all-cause mortality between patients with classical severe low-flow low-gradient and normal-flow low-gradient aortic stenosis (6.81% vs. 4.32%, P=0.49).
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