What is the clinical evidence from this study?

Study design: Observational. Population: Mortality after transcatheter aortic valve implantation (TAVI) (n=72). Intervention: Autopsy vs. Clinically determined cause of death. Primary outcome: Unexpected findings at autopsy resulting in a partly or completely different cause of death compared to clinical determination.

January 27, 2017Virchows ArchivOpen Access

Autopsy after transcatheter aortic valve implantation

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Key result

Autopsy after transcatheter aortic valve implantation revealed unexpected findings in 61.1% of cases, resulting in a partly or completely different cause of death than clinically determined.

Why the study?

Does autopsy provide added value over clinical determination of cause of death in patients who die after TAVI?

Population

72 patients who died after transcatheter aortic valve implantation and underwent autopsy across 8 European…

Comparison

Autopsy vs Clinically determined cause of death

Design

Case_series

Authors

FKFloortje van KesterenAmsterdam UMC Location University of Amsterdam EWEsther WiegerinckBrigham and Women's Hospital SRStefania RizzoElectrophysiology

Discussion

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Implication

Autopsy may reveal clinically unrecognized causes of death after TAVI; leaves open its role in procedural quality assessment.

Study Design

Type

Observational (n=72)

Multicenter

Yes

Structured PICO

Does autopsy provide added value over clinical determination of cause of death in patients who die after TAVI?

Population

72 deceased patients who had undergone transcatheter aortic valve implantation, evaluated via autopsy to determine the cause of death across different post-procedural time intervals.

Exposure

Autopsy

Comparator

Clinically determined cause of death

Outcome

Cause of death and added value of autopsy over solely clinically determined cause of death

Autopsy after TAVI frequently reveals unexpected findings and alters the clinically determined cause of death, highlighting its ongoing diagnostic value.

Limitations

Retrospective analysis without a standardized autopsy protocol.
Overrepresentation of transapical procedures compared to typical clinical practice.
Procedures spanned 2007 to 2015, during which TAVI techniques and prostheses evolved.
Potential selection bias, as autopsies may have been requested more frequently when the clinical cause of death was unclear.
Lack of detailed information on overall autopsy rates among all TAVI patients who died in the participating institutes.

Cite This Study

Kesteren et al. (2017) conducted an observational in Mortality after transcatheter aortic valve implantation (TAVI) (n=72). Autopsy vs. Clinically determined cause of death was evaluated on Unexpected findings at autopsy resulting in a partly or completely different cause of death compared to clinical determination. Autopsy after transcatheter aortic valve implantation revealed unexpected findings in 61.1% of cases, resulting in a partly or completely different cause of death than clinically determined.

synapsesocial.com/papers/6a35da46a4e90ae4d3ef5029 https://doi.org/10.1007/s00428-017-2076-4

Topics

Transcatheter aortic valve replacement TAVR in low-risk patients

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Autopsy after transcatheter aortic valve implantation

Discussion

Member takes

Implication

Study Design

Structured PICO

Limitations

Cite This Study

Topics

Autopsy after transcatheter aortic valve implantation

Discussion

Member takes

Implication

Study Design

Structured PICO

Limitations

Cite This Study

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