scholarly journals TCT-777 Long-term Clinical Outcomes in Nonagenarian Patients Undergoing Transcatheter Aortic Valve Implantation: Multicenter Brazilian Registry

2013 ◽  
Vol 62 (18) ◽  
pp. B236
Author(s):  
Gabriela Campos Cardoso de Lima ◽  
Dimytri A. Siqueira ◽  
Luiz Antonio Carvalho ◽  
Rogério Rogério Sarmento-Leite ◽  
Jose A. Mangione ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Clinical Outcomes ◽  
Transcatheter Aortic Valve Implantation ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

scholarly journals Association of comorbid burden with clinical outcomes after transcatheter aortic valve implantation

Heart ◽  
2018 ◽  
Vol 104 (24) ◽  
pp. 2058-2066 ◽  
Author(s):  
Rodrigo Bagur ◽  
Glen Philip Martin ◽  
Luis Nombela-Franco ◽  
Sagar N Doshi ◽  
Sudhakar George ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Clinical Outcomes ◽  
Transcatheter Aortic Valve Implantation ◽  
Meta Analysis ◽  
Weak Correlation ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation ◽  
Long Term Mortality

ObjectivesTo investigate the association of the CharlsonComorbidity Index (CCI) with clinical outcomes after transcatheter aortic valve implantation (TAVI).BackgroundPatients undergoing TAVI have high comorbid burden; however, there is limited evidence of its impact on clinical outcomes.MethodsData from 1887 patients from the UK, Canada, Spain, Switzerland and Italy were collected between 2007 and 2016. The association of CCI with 30-day mortality, Valve Academic Research Consortium-2 (VARC-2) composite early safety, long-term survival and length of stay (LoS) was calculated using logistic regression and Cox proportional hazard models, as a whole cohort and at a country level, through a two-stage individual participant data (IPD) random effect meta-analysis.ResultsMost (60%) of patients had a CCI ≥3. A weak correlation was found between the total CCI and four different preoperative risks scores (ρ=0.16 to 0.29), and approximately 50% of patients classed as low risk from four risk prediction models still presented with a CCI ≥3. Per-unit increases in total CCI were not associated with increased odds of 30-day mortality (OR 1.09, 95% CI 0.96 to 1.24) or VARC-2 early safety (OR 1.04, 95% CI 0.96 to 1.14) but were associated with increased hazard of long-term mortality (HR 1.10, 95% CI 1.05 to 1.16). The two-stage IPD meta-analysis indicated that CCI was not associated with LoS (HR 0.97, 95% CI 0.93 to 1.02).ConclusionIn this multicentre international study, patients undergoing TAVI had significant comorbid burden. We found a weak correlation between the CCI and well-established preoperative risks scores. The CCI had a moderate association with long-term mortality up to 5 years post-TAVI.

Abstract 13947: The Acute and Long-term Effects of Transcatheter Aortic Valve Implantation on Aortic Stiffness and Hemodynamics

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Vasiliki Gardikioti ◽  
Dimitrios Terentes-printzios ◽  
Konstantinos Aznaouridis ◽  
George Latsios ◽  
Gerasimos Siasos ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Arterial Stiffness ◽  
Transcatheter Aortic Valve Implantation ◽  
Augmentation Index ◽  
Long Term Effects ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
One Year ◽  
Valve Implantation

Introduction: Transcatheter aortic valve implantation (TAVI) is a procedure that alters dramatically the hemodynamics in patients with severe aortic valve stenosis who undergo this procedure. Hypothesis: We investigated the hypothesis that arterial properties and hemodynamics are affected immediately after TAVI as well as in the long-term. Methods: We enrolled 90 patients (mean age 80.2 ± 8.1 years, 50% males) with severe symptomatic aortic stenosis undergoing TAVI. Carotid-femoral and brachial-ankle pulse wave velocity (cfPWV and baPWV) were used for the assessment of arterial stiffness. Augmentation index corrected for heart rate (AIx@75) and subendocardial viability ratio (SEVR) were measured non-invasively. Measurements were conducted at baseline, after the procedure (during hospitalization) and at 1 year. Results: Acutely after TAVI we observed a statistically significant increase in arterial stiffness (7.5 ± 1.5 m/s vs 8.4 ± 1.9 m/s, p=0.001 for cfPWV and 1,773 ± 459 cm/s vs 2,383 ± 645 cm/s, p<0.001 for baPWV) without a concomitant change in systolic blood pressure (Figure). One year later, arterial stiffness was still increased compared to pre-TAVI measurements (7.5 ± 1.5 m/s vs 8.7 ± 1.7 m/s, p<0.001 for cfPWV and 1,773 ± 459 cm/s vs 2,286 ± 575 cm/s, p<0.001 for baPWV). We also found a decrease in AIx@75 (32.2 ± 12.9 % vs 27.9± 8.4 %, p=0.016) after TAVI that was attenuated at 1-year follow-up (32.2 ± 12.9 % vs 29.8± 9.1 %, p=0.38). SEVR displayed an increase acutely after TAVI (131.2 ± 30.0 % vs 148.4± 36.1 %, p=0.002) and remained improved 1 year after the procedure (131.2 ± 30.0 % vs 146± 32.2 %, p=0.01). Conclusions: In conclusion, shortly after TAVI the aorta exhibits a "stiffer" behavior in response to the acute change in hemodynamics, which settles in the long term. Our findings further elucidate the hemodynamic consequences of TAVI and may entail a prognostic role in this growing population.

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