OBJECTIVES: To determine the prevalence of impaired left ventricular (LV) systolic function and its impact on the in-hospital and long-term outcome in patients who underwent Transcatheter Aortic Valve Implantation (TAVI). BACKGROUND: Although impaired LV function may be considered a contra-indication for aortic valve replacement, the hemodynamic characteristics of transcatheter valves may offer procedural and long-term clinical benefit in such patients. METHODS: 230 consecutive patients underwent TAVI with the Medtronic-CoreValve System. Impaired LV function was defined by a Left Ventricular Ejection Fraction (LVEF) ≤ 35% (European Multicenter Study on Operative Risk Stratification and Long-term Outcome in patients with Low-Flow/Low-Gradient Aortic Stenosis). Study endpoints were selected and defined according to the Valve Academic Research Consortium recommendations. RESULTS: Compared with patients with a LVEF > 35% (n = 197), those with LVEF ≤ 35% (n = 33) were more often male (78.8 % vs. 46.7%, P < 0.001), more symptomatic (NYHA class III or IV, 97.0% vs. 77.2%, P = 0.008) and had a higher prevalence of prior coronary artery disease (63.6% vs. 43.1%, P = 0.029). The Logistic EuroSCORE was 14.8% and 22.8, respectively (P = 0.012). No difference was observed between the two groups in in-hospital or 30-day mortality (3.0% vs. 9.6%, P = 0.21), the Combined Safety Endpoint at 30 days (24.2% and 24.4%, P = 0.99) and survival free from readmission at one year (69.2% and 69.7%, P = 0.85). After adjustment, LVEF ≤ 35% was not associated with an increased risk of 30-day mortality, in-hospital complications and survival free from readmission at follow-up. CONCLUSION: The immediate and long-term outcome after TAVI did not differ between patients with an impaired and preserved LVEF. LVEF ≤ 35% did not predict adverse immediate and long-term outcome. These findings suggest that TAVI should not be withheld in selected patients with impaired LV function.
OBJECTIVES: To determine the prevalence of impaired left ventricular (LV) systolic function and its impact on the in-hospital and long-term outcome in patients who underwent Transcatheter Aortic Valve Implantation (TAVI). BACKGROUND: Although impaired LV function may be considered a contra-indication for aortic valve replacement, the hemodynamic characteristics of transcatheter valves may offer procedural and long-term clinical benefit in such patients. METHODS: 230 consecutive patients underwent TAVI with the Medtronic-CoreValve System. Impaired LV function was defined by a Left Ventricular Ejection Fraction (LVEF) ≤ 35% (European Multicenter Study on Operative Risk Stratification and Long-term Outcome in patients with Low-Flow/Low-Gradient Aortic Stenosis). Study endpoints were selected and defined according to the Valve Academic Research Consortium recommendations. RESULTS: Compared with patients with a LVEF > 35% (n = 197), those with LVEF ≤ 35% (n = 33) were more often male (78.8 % vs. 46.7%, P < 0.001), more symptomatic (NYHA class III or IV, 97.0% vs. 77.2%, P = 0.008) and had a higher prevalence of prior coronary artery disease (63.6% vs. 43.1%, P = 0.029). The Logistic EuroSCORE was 14.8% and 22.8, respectively (P = 0.012). No difference was observed between the two groups in in-hospital or 30-day mortality (3.0% vs. 9.6%, P = 0.21), the Combined Safety Endpoint at 30 days (24.2% and 24.4%, P = 0.99) and survival free from readmission at one year (69.2% and 69.7%, P = 0.85). After adjustment, LVEF ≤ 35% was not associated with an increased risk of 30-day mortality, in-hospital complications and survival free from readmission at follow-up. CONCLUSION: The immediate and long-term outcome after TAVI did not differ between patients with an impaired and preserved LVEF. LVEF ≤ 35% did not predict adverse immediate and long-term outcome. These findings suggest that TAVI should not be withheld in selected patients with impaired LV function.
Authors: Gerhard Schymik; Panagiotis Tzamalis; Valentin Herzberger; Jens Bergmann; Peter Bramlage; Alexander Würth; Lars Oliver Conzelmann; Armin Luik; Holger Schröfel Journal: Clin Res Cardiol Date: 2017-08-21 Impact factor: 5.460
Authors: X Luo; Z Zhao; H Chai; C Zhang; Y Liao; Q Li; Y Peng; W Liu; X Ren; Q Meng; C Chen; M Chen; Y Feng; D Huang Journal: Herz Date: 2015-02-26 Impact factor: 1.443
Authors: Joud Al Balool; Mohammed Al Jarallah; Rajesh Rajan; Raja Dashti; Nader Alasousi; Vladimir Kotevski; Ahmed Said Taha Mousa; Retaj Al Haroun; Gary Tse; Kobalava D Zhanna; Parul Setiya; Ahmad Al Saber; Peter A Brady Journal: Ann Med Surg (Lond) Date: 2022-05-07
Authors: Suzanne J Baron; Suzanne V Arnold; Howard C Herrmann; David R Holmes; Wilson Y Szeto; Keith B Allen; Adnan K Chhatriwalla; Sreekaanth Vemulapali; Sean O'Brien; Dadi Dai; David J Cohen Journal: J Am Coll Cardiol Date: 2016-05-24 Impact factor: 24.094
Authors: Edward T Carreras; Tsuyoshi Kaneko; Fernando Ramirez-Del Val; Marc P Pelletier; Piotr S Sobieszczyk; Deepak L Bhatt; Pinak B Shah Journal: Catheter Cardiovasc Interv Date: 2017-10-08 Impact factor: 2.692