Key result
Transcatheter aortic valve implantation in high-risk or inoperable patients with severe aortic stenosis demonstrated 30-day and 1-year mortality rates of 5.7% and 11.5%, respectively.
Why the study?
Does transcatheter aortic valve implantation provide safe and effective outcomes in high surgical risk and inoperable patients with severe aortic stenosis?
Cohort (n=209)
No
Does transcatheter aortic valve implantation provide safe and effective outcomes in high surgical risk and inoperable patients with severe aortic stenosis?
Answers are grounded in this paper and cite their sources.
TAVI is a feasible and safe option for high surgical risk and inoperable patients with severe aortic stenosis, demonstrating acceptable 1-year mortality and stroke rates in a real-world Australian cohort.
BACKGROUND: Degenerative aortic stenosis is the most common valvular heart disease in the elderly, and many patients are not suitable for aortic valve replacement surgery. Transcatheter aortic valve implantation (TAVI) is a new therapeutic option for selected patients at high risk for surgery. AIM: To evaluate the safety and efficacy of TAVI in Australian patients. METHODS: This is a prospective study of patients undergoing TAVI for severe symptomatic aortic stenosis at The Prince Charles Hospital, Brisbane, Australia between August 2008 and July 2013. Patients were at high risk of surgical aortic valve replacement, or inoperable, as deemed by a multidisciplinary 'heart team'. Outcomes include procedural success and complications, 30-day and 1-year mortality and stroke, combined end-points as outlined by the Valve Academic Research Consortium 2 consensus document. RESULTS: Two hundred and nine patients underwent TAVI during the study period. The mean age was 83.7 ± 6.7 years, and 101 (48%) were men. The valve systems utilised were as follows: Edwards-SAPIEN valve in 104 (49.5%), Medtronic CoreValve in 86 (41.2%) and Boston Scientific Lotus valve in 19 (9.3%) patients. Thirty-day and 1-year mortality rates were 5.7% and 11.5% respectively. Thirty-day and 1-year stroke rates were 4.3% and 6.2% respectively. The composite end-points of device success, early safety and clinical efficacy occurred in 80.4%, 27.3% and 68.4%. CONCLUSIONS: TAVI with various valve systems, delivered through several approaches, is feasible in high surgical risk and inoperable patients with severe aortic stenosis, with acceptable outcomes at short-term and intermediate-term follow up.
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Subban et al. (2015) conducted a cohort in severe symptomatic aortic stenosis (n=209). Transcatheter aortic valve implantation (TAVI) was evaluated on Procedural success and complications, 30-day and 1-year mortality and stroke, and VARC-2 combined end-points. Transcatheter aortic valve implantation in high-risk or inoperable patients with severe aortic stenosis demonstrated 30-day and 1-year mortality rates of 5.7% and 11.5%, respectively.
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