Key result
Transapical TAVR yields comparable all-cause mortality across all patient age groups.
Why the study?
Transcatheter aortic valve replacement via a transapical approach has been associated with high morbidity, prompting investigation into the association of age with clinical and functional outcomes.
Does age affect overall all-cause mortality and clinical outcomes in patients undergoing transapical transcatheter aortic valve replacement?
Cohort (n=117)
No
Does age affect overall all-cause mortality and clinical outcomes in patients undergoing transapical transcatheter aortic valve replacement?
Answers are grounded in this paper and cite their sources.
In patients undergoing transapical TAVR, frailty rather than age is an independent predictor of all-cause mortality, indicating that advanced age alone should not preclude patients from the procedure.
OBJECTIVE: Transcatheter aortic valve replacement (TAVR) via a transapical (TA) approach has been associated with high morbidity. The aim of this study is to investigate the association of age and clinical and functional outcomes after TA-TAVR. METHODS: Patients who had TA-TAVR at a single center were divided into 3 age groups: <75 years (Group I), 75 to 85 years (Group II), and >85 years (Group III). Pre- and postoperative clinical, functional status, and procedure-related outcomes were compared among patient groups. A multivariable Cox proportional hazards model was used to assess the impact of age on overall all-cause mortality. RESULTS: Out of 183 TA-TAVR cases performed, 117 met the study criteria. These included 15 aged <75 years, 60 aged 75 to 85 years, and 42 aged >85 years. Short-term (30-day) clinical and functional status improved significantly for all age groups. The incidence of acute kidney injury, access site complications, and requirement for permanent pacemaker were similar for all age groups at 30 days. After a median follow-up of 26 months, overall all-cause survival rates were 86% for Group I, 88% for Group II, and 83% for Group III at 1 year. Cox proportional hazards model showed frailty status (HR: 1.84; 95% CI, 1.23 to 2.69; P = 0.003) but not age as an independent predictor of overall all-cause mortality. CONCLUSIONS: Findings from this study suggest that both older and younger patients benefit from TA-TAVR with comparable operative outcomes. Age should not be an exclusion criterion for TA-TAVR.
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Okoh et al. (2019) conducted a cohort in Aortic valve disease requiring TA-TAVR (n=117). Age vs. Different age groups (<75, 75-85, >85 years) was evaluated on Overall all-cause mortality. Age was not an independent predictor of overall all-cause mortality after transapical TAVR, with comparable 1-year survival rates of 86%, 88%, and 83% across age groups <75, 75-85, and >85 years.
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