Τίτλος:
Long-Term Outcomes and Valve Performance in Patients Undergoing
Transcatheter Aortic Valve Implantation
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Transcatheter aortic valve implantation (TAVI) is an established method
for treating patients with aortic valve stenosis. We sought to determine
the long-term clinical outcomes and performance of a self-expanding
bioprosthesis beyond 5 years. Consecutive patients scheduled for TAVI
were included in the analysis. Primary end points were all-cause and
cardiovascular mortality, structural valve deterioration (SVD) and
bioprosthetic valve failure (BVF), based on the VARC-2 criteria and
consensus statement by ESC/EAPCI. The study prospectively evaluated 273
patients (80.61 +/- 7.00 years old, 47% females) who underwent TAVI
with CoreValve/Evolut-R (Medtronic Inc.). The median follow-up duration
was 5 years (interquartile range: 2.9 to 6; longest: 8 years). At 1, 5,
and 8 years, estimated survival rates were 89.0%, 61.1%, and 56.0%,
respectively, while cardiovascular mortality was 8% at the end of
follow-up. Regarding valve performance, 5% of patients had early BVF
and 1% had late BVF. Concerning SVD, 16 patients (6% of the total
population) had moderate SVD (91% had an increase in mean gradient),
with no severe SVD cases. Five patients with SVD died during follow-up.
Actual analysis of the 8-year cumulative incidence of function of
moderate SVD was 5.9% (2.5% to 16.2%). At multivariate analysis, the
factor that emerged as an independent predictor for future SVD, was
smaller bioprosthetic valve size (HR 0.58, 95% CI 0.41 to 0.82, p =
0.002). Long-term evaluation beyond 5 years after TAVI with a
self-expanding bioprosthesis demonstrated low rates of cardiovascular
mortality and structural valve deterioration. Valve size was an
independent predictor for SVD. (C) 2021 Elsevier Inc. All rights
reserved.
Συγγραφείς:
Stathogiannis, Konstantinos
Synetos, Andreas
Latsios, George and
Karanasos, Antonios
Trantalis, George
Toskas, Pantelis and
Drakopoulou, Maria
Xanthopoulou, Maria
Karmpalioti, Maria and
Simopoulou, Chryssa
Soulaidopoulos, Stergios
Oikonomou, George
and Benetos, Georgios
Tsalamandris, Sotirios
Kosmas, Ilias and
Voudris, Vasilis
Mastrokostopoulos, Antonios
Katsimagklis,
George
Halvatsiotis, Panos
Deftereos, Spyridon
Tsioufis,
Costas
Toutouzas, Konstantinos
Περιοδικό:
AMERICAN JOURNAL OF CARDIOLOGY
Εκδότης:
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI:
10.1016/j.amjcard.2021.02.006
