Key result
Urgent TAVI shows similar 1-year mortality compared to elective TAVI.
Why the study?
TAVI is increasingly performed during unscheduled index hospital admissions, but procedural and mid-term outcomes comparing elective versus urgent in-hospital TAVI are not well characterized.
Does urgent in-hospital TAVI result in similar procedural outcomes and mortality compared to elective TAVI in patients requiring transcatheter aortic valve implantation?
Cohort (n=1,157)
No
Does urgent in-hospital TAVI result in similar procedural outcomes and mortality compared to elective TAVI in patients requiring transcatheter aortic valve implantation?
Absolute Event Rate: 11% vs 10.9%
p-value: p=0.81
Urgent TAVI performed during an unscheduled index admission has similar procedural success and up to 1-year mortality compared to elective TAVI.
Supports similar 1-year mortality with urgent TAVI in selected patients; hypothesis-generating and requires randomized confirmation before practice change.
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is maturing as a treatment option and is now often undertaken during an unscheduled index hospital admission. The aim of this study was to look at procedural and mid-term outcomes of patients undergoing elective versus urgent in-hospital transcatheter aortic valve implantation. METHODS: We identified a total of 1,157 patients who underwent TAVI between November 2007 and November 2019 at the Sussex Cardiac Centre in the UK. We compared the demographics, procedural outcomes, 30-day and 1-year mortality between elective and urgent patients. Emergency and salvage TAVI cases were excluded. RESULTS: Of the 1,157 patients who underwent the procedure, 975 (84.3%) had elective while 182 (15.7%) had urgent TAVI. Predominant aortic stenosis was more frequent in elective patients (91.7% vs. 77.4%); p < .01), while predominant aortic regurgitation was seen more commonly in the urgent group (11.5% vs. 4.2%; p < .01). Implantation success was similar between the elective (99.1%) and urgent group (99.4%). In-hospital (1.65% vs. 1.3%: p .11), 30 day (3.5% vs. 3.3%: p .81) and 1 year (10.9% vs. 11%; p .81) mortality rates were similar in the elective and urgent groups, respectively. CONCLUSIONS: In contemporary practice, urgent TAVI undertaken on the index admission can be performed at similar risk to elective outpatient TAVI.
No takes yet. Share an insight, caveat, or question.
Kabahizi et al. (2021) conducted a cohort in Aortic valve disease requiring TAVI (n=1,157). Urgent TAVI vs. Elective TAVI was evaluated on 1-year mortality (p=0.81). Urgent transcatheter aortic valve implantation had similar 1-year mortality compared to elective TAVI (11.0% vs 10.9%; p=0.81).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: