BACKGROUND: Few data exist about transcatheter aortic valve implantation (TAVI) in patients with low ejection fraction. The aim of the study was to analyze safety, feasibility, and efficacy of TAVI in patients with severe left ventricular dysfunction. METHODS AND RESULTS: The study sample (384 patients) was divided into 2 groups: group A (50 patients) with left ventricular ejection fraction (LVEF) ≤35%, and group B (334 patients) with LVEF >35%. Clinical, anatomic, and hemodynamic variables, as well as procedural results and follow-up outcomes, were compared between the groups. Procedural success was reached in 88%, with no significant difference between the groups. The incidence of periprosthetic leak >2+/4 after TAVI was higher in group A. All other complications were similar between the 2 groups. Group A showed a significant and early improvement in LVEF (from 27.7±6.0-35.2±11.1 after TAVI; P<0.0001). Thirty-day mortality was 4%; however, this was higher in group A compared with group B (10% versus 3%; P=0.010). Predictors of the cumulative late mortality were congestive heart failure, logistic euroSCORE, and moderate-to-severe periprosthetic leakage after TAVI. Estimated survival by Kaplan Meier at 1 year was, respectively, 69% in group A and 87% in group B (log rank <0.0001). CONCLUSIONS: Transcatheter aortic valve implantation is a safe and effective procedure, even in patients with severe left ventricular dysfunction, leading to a high procedural success rate with an acceptable rate of complications and 30-day mortality. Also in these critically ill patients, TAVI provides clinical amelioration, with early improvement in LVEF.
BACKGROUND: Few data exist about transcatheter aortic valve implantation (TAVI) in patients with low ejection fraction. The aim of the study was to analyze safety, feasibility, and efficacy of TAVI in patients with severe left ventricular dysfunction. METHODS AND RESULTS: The study sample (384 patients) was divided into 2 groups: group A (50 patients) with left ventricular ejection fraction (LVEF) ≤35%, and group B (334 patients) with LVEF >35%. Clinical, anatomic, and hemodynamic variables, as well as procedural results and follow-up outcomes, were compared between the groups. Procedural success was reached in 88%, with no significant difference between the groups. The incidence of periprosthetic leak >2+/4 after TAVI was higher in group A. All other complications were similar between the 2 groups. Group A showed a significant and early improvement in LVEF (from 27.7±6.0-35.2±11.1 after TAVI; P<0.0001). Thirty-day mortality was 4%; however, this was higher in group A compared with group B (10% versus 3%; P=0.010). Predictors of the cumulative late mortality were congestive heart failure, logistic euroSCORE, and moderate-to-severe periprosthetic leakage after TAVI. Estimated survival by Kaplan Meier at 1 year was, respectively, 69% in group A and 87% in group B (log rank <0.0001). CONCLUSIONS: Transcatheter aortic valve implantation is a safe and effective procedure, even in patients with severe left ventricular dysfunction, leading to a high procedural success rate with an acceptable rate of complications and 30-day mortality. Also in these critically ill patients, TAVI provides clinical amelioration, with early improvement in LVEF.
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: Patrycjusz Stokłosa; Piotr Szymański; Maciej Dąbrowski; Dariusz Zakrzewski; Piotr Michałek; Ewa Orłowska-Baranowska; Kamal El-Hassan; Zbigniew Chmielak; Adam Witkowski; Tomasz Hryniewiecki Journal: Postepy Kardiol Interwencyjnej Date: 2015-03-06 Impact factor: 1.426
Authors: Leonardo Sinnott Silva; Paulo Ricardo Avancini Caramori; Antonio Carlos Bacelar Nunes Filho; Marcelo Katz; João Carlos Vieira da Costa Guaragna; Pedro Lemos; Valter Lima; Alexandre Abizaid; Flavio Tarasoutchi; Fabio S de Brito Journal: Arq Bras Cardiol Date: 2015-07-31 Impact factor: 2.000