Aortic valve replacement: Results and predictors of mortality from a contemporary series of 2256 patients

Eusanio, Marco Di; Fortuna, Daniela; Palma, Rossana De; Dell’Amore, Andrea; Lamarra, Mauro; Contini, Giovanni; Gherli, Tiziano; Gabbieri, Davide; Ghidoni, Italo; Cristell, Donald; Zussa, Claudio; Pigini, F; Pugliese, Peppino; Pacini, Davide; Bartolomeo, Roberto Di

doi:10.1016/j.jtcvs.2010.05.044

Cited by 96 publications

(64 citation statements)

References 24 publications

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“…In contrast, PH has early clinical implications after surgical AVR: Melby et al, 24 in 1080 patients who underwent AVR for primary aortic valve stenosis, found significantly higher 30-day mortality in patients with PH (9.3% versus 5.4%; P=0.18). Severe PH was also an independent predictor of early mortality in the study of Di Eusanio et al 25 of 2256 patients managed by AVR (odds ratio, 5; 95% CI, 1.1-5.9).…”

Section: Discussionmentioning

confidence: 92%

Prognostic Implications of Pulmonary Hypertension in Patients With Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation

Luçon

Oger

Bédossa

et al. 2014

Circ: Cardiovascular Interventions

108

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Background-Pulmonary hypertension (PH) is associated with poor prognosis in patients with severe aortic stenosis. The aim of this multicenter study was to describe clinical outcome after transcatheter aortic valve implantation. Methods and Results-The FRANCE 2 Registry included all patients undergoing transcatheter aortic valve implantation in France in 2010 and 2011. Patients were divided into 3 groups depending on systolic pulmonary artery pressure (sPAP) estimated in transthoracic echocardiography: group I, sPAP <40 mm Hg (no PH); group II, sPAP 40 to 59 mm Hg (mildto-moderate PH); and group III, sPAP ≥60 mm Hg (severe PH). Patients were followed up for 1 year. A total of 2435 patients whose pre-transcatheter aortic valve implantation sPAP was reported were included. A total of 845 were in group I (34.7%), 1112 in group II (45.7%), and 478 in group III (19.6%). Procedural success, early complications, and 30-day mortality were statistically similar across sPAP groups. One-year mortality was higher in groups II and III (group I, 22%; group II, 28%; and group III, 28%; P=0.032). Mild-to-moderate and severe PH were identified as an independent factor of all-cause mortality. The major adverse cardiovascular event rates did not differ according to sPAP. New York Health Association functional class improved significantly in all groups. Conclusions-PH (sPAP ≥40 mm Hg) in patients with aortic stenosis undergoing transcatheter aortic valve implantation was associated with increased 1-year mortality especially when severe (sPAP ≥60 mm Hg) but not with increased 30-day mortality, and functional status was significantly improved regardless of PAP level. (Circ Cardiovasc Interv. 2014;7:240-247.)

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Section: Discussionmentioning

confidence: 92%

Prognostic Implications of Pulmonary Hypertension in Patients With Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation

Luçon

Oger

Bédossa

et al. 2014

Circ: Cardiovascular Interventions

108

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“…16) Di Eusanio, et al reported that octogenarians had significant higher incidence of both hospital mortality and postoperative complications such as renal failure, stroke, atrial fibrillation, and third degree atrioventricular block. 17) Handa, et al recently examined 7883 Japanese patients who underwent cAVR by using the Japanese Adult Cardiovascular Surgery Database to assess the risk stratification for potential TAVR candidates and reported that the early mortality in the patients over 80 years old was significantly higher than those under 70 years old (5.2% vs. 2.1%). 2) Age is an important negative factor for decision making in performing cAVR.…”

Section: Is Older Age An Operative Risk For Cavr?mentioning

confidence: 99%

Characteristics of Inoperable Patients with Severe Aortic Valve Stenosis —In the Era of Transcatheter Aortic Valve Replacement

Seki

Sakakibara

Shingu

et al. 2015

ATCS

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Purpose: Transcatheter aortic valve replacement (TAVR) has emerged as a therapeutic option for severe aortic valvular stenosis (AS). To determine the indication for TAVR, it is mandatory to clarify the characteristics of the patients who were judged as inoperable for conventional aortic valve replacement (cAVR). Methods: Of 185 patients newly diagnosed as severe AS from March 2010 to April 2011, we studied the characteristics of 61 (33%) patients (mean age, 86 ± 8 years) who were judged as inoperable. Results: Younger patients (<85 years old, n = 22) had more major comorbidities and lower left ventricular ejection fraction than older patients (≥85 years old, n = 39). Mean estimated mortality for cAVR by Japan score was 7.0% ± 7.4%. Japan score did not correlate to age and was calculated relatively low in the older age group (6.2% ± 7.0%) than the younger age group (8.3% ± 8.1%). Conclusion: One thirds of severe AS patients were judged as inoperable. In advanced age patients, age itself and other factors, which are not included in the conventional scoring systems, might have contributed to the decision making not to perform cAVR by cardiologists. Further study is necessary to define risk factors except for age.

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“…The only effective treatment of AS is aortic valve replacement [21,26]. The effect of concomitant hypertension on long-term fate of patients after aortic valve replacement is not fully understood [50][51][52][53][54][55][56][57].…”

Section: Aortic Valve Replacement: When To Perform In Patients With Amentioning

confidence: 99%

Hypertension in aortic stenosis: More questions than answers

Orłowska−Baranowska¹

2013

Cardiol J.

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Aortic valve replacement: Results and predictors of mortality from a contemporary series of 2256 patients

Abstract: This study provides contemporary data on the characteristics and outcome of patients undergoing first-time isolated aortic valve replacement.

Cited by 96 publications

References 24 publications

Prognostic Implications of Pulmonary Hypertension in Patients With Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation

Prognostic Implications of Pulmonary Hypertension in Patients With Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation

Characteristics of Inoperable Patients with Severe Aortic Valve Stenosis —In the Era of Transcatheter Aortic Valve Replacement

Hypertension in aortic stenosis: More questions than answers

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