What question did this study set out to answer?

To evaluate the impact of different valve prostheses and surgical access routes on perioperative, short-term, and mid-term prognosis in patients with critical aortic stenosis and comorbidities.

January 1, 2016Rational Pharmacotherapy in CardiologyOpen Access

The Prognosis in Transcatheter Aortic Valve Implantation

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: critical aortic stenosis and comorbidities (n=130). Intervention: Transcatheter aortic valve implantation (TAVI) vs. Different valve types and surgical access (CoreValve vs Edwards transfemoral vs Edwards transapical). Primary outcome: 1-year survival (p=>0.05).

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Key result

TAVI in patients with critical aortic stenosis resulted in a 6.9% hospital mortality, with no significant difference in 1-year survival between CoreValve, Edwards transfemoral, and Edwards transapical approaches (p>0.05).

Why the study?

Does valve type or surgical access affect mortality in high-risk patients undergoing TAVI for critical aortic stenosis?

Population

130 patients with critical aortic stenosis and comorbidities (high surgical risk)

Design

Cohort

Follow-up

Mean 2.2 years (range 0.2 to 5.2 years)

Authors

ТИТ. Э. ИмаевNational Medical Research Center of Cardiology АКА. Е. КомлевNational Medical Research Center of Cardiology ARAkchurin RsNational Medical Research Center of Cardiology

Discussion

Member takes

Implication

TAVI outcomes in comorbid aortic stenosis may differ by prosthesis and access; leaves open optimal selection pending randomized comparisons.

Key Points

To evaluate the impact of different valve prostheses and surgical access routes on perioperative, short-term, and mid-term prognosis in patients with critical aortic stenosis and comorbidities.
Analyzed 130 consecutive patients undergoing TAVI with an Edwards valve via transfemoral (n=50) or transapical (n=30) access, or with a CoreValve system (n=50).
Recorded perioperative complications, 30-day mortality, and post-hospital survival over a mean follow-up of 2.2 years (range: 0.2 to 5.2 years).
Hospital mortality averaged 6.9% across the cohort, with an additional 14.8% mortality observed during the post-hospital follow-up period.
One-year survival rates were 86.9% for CoreValve, 88.0% for transfemoral Edwards, and 85.4% for transapical Edwards; two-year survival rates were 77.5%, 82.5%, and 82.7%, respectively (p>0.05 across all groups).
Male patients experienced over 2.5 times higher mortality than females, with atrioventricular block, pacemaker placement, chronic obstructive pulmonary disease, stroke, and renal failure serving as major prognostic factors.

Study Design

Type

Cohort (n=130)

Structured PICO

Does valve type or surgical access affect mortality in high-risk patients undergoing TAVI for critical aortic stenosis?

Population

130 patients with critical aortic stenosis and comorbidities undergoing TAVI with Edwards or CoreValve systems, followed for a mean of 2.2 years.

Exposure

Transcatheter aortic valve implantation (TAVI) using Edwards valve via transfemoral (n=50) or transapical (n=30) access, or CoreValve system (n=50)

Outcome

Mortality (perioperative, total 30-day, and post-hospital mortality, as well as 1-year and 2-year survival)hard clinical

Main Result

Absolute Event Rate: 86.9% vs 88%

p-value: p=>0.05

TAVI provides reasonable 1- and 2-year survival in high-risk patients with critical aortic stenosis, with outcomes independent of the specific valve type or access route used.

Cite This Study

Имаев et al. (2016) conducted a cohort in critical aortic stenosis and comorbidities (n=130). Transcatheter aortic valve implantation (TAVI) vs. Different valve types and surgical access (CoreValve vs Edwards transfemoral vs Edwards transapical) was evaluated on 1-year survival (p=>0.05). TAVI in patients with critical aortic stenosis resulted in a 6.9% hospital mortality, with no significant difference in 1-year survival between CoreValve, Edwards transfemoral, and Edwards transapical approaches (p>0.05).

synapsesocial.com/papers/6a97c169da663e44ef76f883 https://doi.org/10.20996/1819-6446-2016-12-6-718-724

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Implication

TAVI outcomes in comorbid aortic stenosis may differ by prosthesis and access; leaves open optimal selection pending randomized comparisons.

The Prognosis in Transcatheter Aortic Valve Implantation

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

The Prognosis in Transcatheter Aortic Valve Implantation

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

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