Abstract 313: Risk Factors for Mortality in Patients with Severe Aortic Stenosis Referred for Transcatheter Aortic Valve Implantation Who Remain Untreated

Abstract

Background: The availability of transcatheter aortic valve replacement (TAVR) has expanded the proportion of patients with severe aortic stenosis (AS) who are candidates for valve replacement. Nevertheless, many patients decline or are not candidates for TAVR or surgical replacement, and their prognosis and risk factors for mortality are incompletely understood. Methods: We examined 148 patients with severe AS referred for TAVR, but not treated with an aortic valve procedure, and with complete echocardiography and at least 3 months of follow-up. We determined all-cause mortality using the social security death index, and compared patient characteristics and echocardiography findings between survivors and non-survivors. Results: Mean age was 78.9±10.4 years, and 53.4% were male. Mean follow-up was 10.3±8.7 months, and death occurred in 63 (42.6%) of patients. Mean follow-up for survivors was 14.4±8.6 months, and mean time to death was 4.7±5.2 months. Cumulative survival was 55.7% and 47.2% at 1 and 2 years, respectively. Table 1 provides unadjusted and adjusted variables associated with all-cause mortality. Conclusions: Patients with severe AS referred for TAVR but remaining untreated experience a mortality rate of nearly 50% at one year. While comorbidities were not associated with mortality, presenting clinical variables and echocardiography findings can identify patients at increased risk of death.