Τίτλος:
Four-Year clinical results of transcatheter Self-Expanding medtronic core valve implantation in High-Risk patients with severe aortic stenosis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Transcatheter aortic valve implantation (TAVI) has emerged as an alternative to surgical aortic valve replacement for patients with severe aortic stenosis considered inoperable or at high operative risk, but the Long-Term outcome remains unknown. Hypothesis: We assessed the 4-Year clinical and echocardiographic outcomes of patients undergoing TAVI with the Self-Expanding Medtronic CoreValve prosthesis. Methods: Sixty-Three patients (mean age 80 ± 6 years) with severe aortic stenosis (AS) at high risk for surgical aortic valve replacement (Logistic EuroSCORE 28.8 ± 10.9%) were included in this study. Results: All-Cause cumulative mortality at 1, 2, 3 and 4 years was 14.3, 25.4, 28.6 and 36.5%, respectively. The cumulative incidence of documented major stroke at 4 years was 6.3%. In survivors, there was a significant improvement in functional status at 4 years. Paravalvular leak (trivial/mild to moderate) was observed in the majority of patients Post-TAVI with no case of progression to severe regurgitation at 4-Year Follow-Up. In multivariate analysis, independent predictor for increased All-Cause mortality was left ventricular ejection fraction <40% (HR: 5.347, 95% CI: 1.126-25.381, P = 0.035). Conclusion: Our study demonstrated favourable Long-Term (4 years) outcomes after successful TAVI using the Third-Generation Medtronic CoreValve device. © The Author 2016.
Συγγραφείς:
Thomopoulou, S.
Vavuranakis, M.
Karyofyllis, P.
Kariori, M.
Karavolias, G.
Balanika, M.
Smyrli, A.
Stefopoulos, C.
Sbarouni, E.
Moldovan, C.
Khoury, M.
Stefanadis, C.
Voudris, V.
Περιοδικό:
Age and Ageing
Εκδότης:
Oxford University Press
Λέξεις-κλειδιά:
aged; all cause mortality; aorta stenosis; aorta valve prosthesis; aorta valve regurgitation; aorta valve replacement; Article; bleeding; cerebrovascular accident; disease course; disease severity; echocardiography; endocarditis; EuroSCORE; female; heart death; heart left ventricle ejection fraction; high risk patient; human; leaflet disruption; major clinical study; male; medical device complication; mortality; multicenter study; New York Heart Association class; outcome assessment; paravalvular leak; priority journal; prospective study; self expanding aorta valve prosthesis; stent fracture; surgical risk; survivor; transcatheter aortic valve implantation; valve migration; very elderly; analysis of variance; aortic valve stenosis; bioprosthesis; cohort analysis; diagnostic imaging; evaluation study; follow up; frail elderly; geriatric assessment; heart valve prosthesis; Kaplan Meier method; nonparametric test; procedures; proportional hazards model; prosthesis design; risk assessment; survival rate; time factor; transcatheter aortic valve implantation; treatment outcome, Aged; Aged, 80 and over; Analysis of Variance; Aortic Valve Stenosis; Bioprosthesis; Cohort Studies; Echocardiography; Female; Follow-Up Studies; Frail Elderly; Geriatric Assessment; Heart Valve Prosthesis; Humans; Kaplan-Meier Estimate; Male; Proportional Hazards Models; Prosthesis Design; Risk Assessment; Statistics, Nonparametric; Survival Rate; Time Factors; Transcatheter Aortic Valve Replacement; Treatment Outcome
DOI:
10.1093/ageing/afw038
