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Transcatheter Aortic Valve Implantation and Morbidity andMortality-Related Factors: a 5-Year Experience in Brazil

View Article: PubMed Central - PubMed

ABSTRACT

Background: Transcatheter aortic valve implantation has become an option forhigh-surgical-risk patients with aortic valve disease.

Objective: To evaluate the in-hospital and one-year follow-up outcomes of transcatheteraortic valve implantation.

Methods: Prospective cohort study of transcatheter aortic valve implantation casesfrom July 2009 to February 2015. Analysis of clinical and proceduralvariables, correlating them with in-hospital and one-year mortality.

Results: A total of 136 patients with a mean age of 83 years (80-87) underwent heartvalve implantation; of these, 49% were women, 131 (96.3%) had aorticstenosis, one (0.7%) had aortic regurgitation and four (2.9%) had prostheticvalve dysfunction. NYHA functional class was III or IV in 129 cases (94.8%).The baseline orifice area was 0.67 ± 0.17 cm2 and the meanleft ventricular-aortic pressure gradient was 47.3±18.2 mmHg, with anSTS score of 9.3% (4.8%-22.3%). The prostheses implanted were self-expandingin 97% of cases. Perioperative mortality was 1.5%; 30-day mortality, 5.9%;in-hospital mortality, 8.1%; and one-year mortality, 15.5%. Bloodtransfusion (relative risk of 54; p = 0.0003) and pulmonary arterialhypertension (relative risk of 5.3; p = 0.036) were predictive ofin-hospital mortality. Peak C-reactive protein (relative risk of 1.8; p =0.013) and blood transfusion (relative risk of 8.3; p = 0.0009) werepredictive of 1-year mortality. At 30 days, 97% of patients were in NYHAfunctional class I/II; at one year, this figure reached 96%.

Conclusion: Transcatheter aortic valve implantation was performed with a high successrate and low mortality. Blood transfusion was associated with higherin-hospital and one-year mortality. Peak C-reactive protein was associatedwith one-year mortality.

No MeSH data available.


Baseline, 30-day, 6-month, and 1-year NYHA functional class. NYHA = NewYork Heart Association.
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f1: Baseline, 30-day, 6-month, and 1-year NYHA functional class. NYHA = NewYork Heart Association.

Mentions: The follow-up lasted 2.5 ± 1.4 years. Progression of symptoms according toNYHA functional classes is shown in Figure1.


Transcatheter Aortic Valve Implantation and Morbidity andMortality-Related Factors: a 5-Year Experience in Brazil
Baseline, 30-day, 6-month, and 1-year NYHA functional class. NYHA = NewYork Heart Association.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940151&req=5

f1: Baseline, 30-day, 6-month, and 1-year NYHA functional class. NYHA = NewYork Heart Association.
Mentions: The follow-up lasted 2.5 ± 1.4 years. Progression of symptoms according toNYHA functional classes is shown in Figure1.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Transcatheter aortic valve implantation has become an option forhigh-surgical-risk patients with aortic valve disease.

Objective: To evaluate the in-hospital and one-year follow-up outcomes of transcatheteraortic valve implantation.

Methods: Prospective cohort study of transcatheter aortic valve implantation casesfrom July 2009 to February 2015. Analysis of clinical and proceduralvariables, correlating them with in-hospital and one-year mortality.

Results: A total of 136 patients with a mean age of 83 years (80-87) underwent heartvalve implantation; of these, 49% were women, 131 (96.3%) had aorticstenosis, one (0.7%) had aortic regurgitation and four (2.9%) had prostheticvalve dysfunction. NYHA functional class was III or IV in 129 cases (94.8%).The baseline orifice area was 0.67 ± 0.17 cm2 and the meanleft ventricular-aortic pressure gradient was 47.3±18.2 mmHg, with anSTS score of 9.3% (4.8%-22.3%). The prostheses implanted were self-expandingin 97% of cases. Perioperative mortality was 1.5%; 30-day mortality, 5.9%;in-hospital mortality, 8.1%; and one-year mortality, 15.5%. Bloodtransfusion (relative risk of 54; p = 0.0003) and pulmonary arterialhypertension (relative risk of 5.3; p = 0.036) were predictive ofin-hospital mortality. Peak C-reactive protein (relative risk of 1.8; p =0.013) and blood transfusion (relative risk of 8.3; p = 0.0009) werepredictive of 1-year mortality. At 30 days, 97% of patients were in NYHAfunctional class I/II; at one year, this figure reached 96%.

Conclusion: Transcatheter aortic valve implantation was performed with a high successrate and low mortality. Blood transfusion was associated with higherin-hospital and one-year mortality. Peak C-reactive protein was associatedwith one-year mortality.

No MeSH data available.