Early‐ and mid‐term outcomes of transcatheter aortic valve implantation in patients with logistic EuroSCORE less than 20%: A comparative analysis between different risk strata

Tamburino, Corrado; Barbanti, Marco; Capodanno, Davide; Sarkar, Kunal; Cammalleri, Valeria; Scarabelli, Marilena; Mulè, Massimiliano; Immè, Sebastiano; Aruta, Patrizia

doi:10.1002/ccd.23100

Cited by 30 publications

(19 citation statements)

References 24 publications

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“…The patients had mean EuroScore of 39.30% and mean STS score of 30.28%, which means that higher mortality rates than the ones described in major studies worldwide [20][21][22][23][24][25][26] can be explained by greater patient severity. A recent study in Italy [29] evaluated 165 patients who had undergone transcatheter aortic valve implantation. They were grouped according to EuroScore, above or below 20%.…”

Section: Discussionmentioning

confidence: 99%

Initial and pioneer experience of transcatheter aortic valve implantation (Inovare) through femoral or iliac artery

Pontes¹,

Duarte²,

Silva³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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208Rev Bras Cir Cardiovasc | Braz J Cardiovasc SurgRev Bras Cir Cardiovasc 2013;28(2):208-16 Pontes JCDV, et al. -Initial and pioneer experience of transcatheter aortic valve implantation (Inovare) through femoral or iliac artery RBCCV 44205-1459 DOI: 10.5935/1678 Initial and pioneer experience of transcatheter aortic valve implantation (Inovare) through femoral or iliac artery Abstract Objective: This paper demonstrates the initial and pioneering experience implant of the Inovare prosthesis implant through transfemoral or iliac artery route.Methods: Six patients underwent transcatheter aortic valve implantation. The access was femoral or iliac through which the delivery device, a latex balloon catheter with the crimped prosthesis, was inserted. Through the femoral introducer 24 Fr Gore ® DrySeal sheath, an extra stiff guide wire with non-traumatic tip was positioned in the left ventricle by passing through the valve ring. After balloon valvuloplasty, in cases of native valve stenosis, the prosthesis implantation was performed after hypotension induced by tachycardia and controlled by temporary pacemaker. The valve positioning was guided by TEE (transesophageal ecocardiography) and fluoroscopy, aiming to position a third of the length of the prosthesis into the left ventricle cavity.Results: The successful valve implantation was possible in six cases. There was no need of conversion to open surgery due to inability to access or graft migration. There were no intraoperative or hospital deaths. We observed a significant reduction in the mean gradient of 66.84±15.46 mmHg to 19.74±10.61 mm Hg postoperatively (P=0.002), a reduction of 70.46%.Conclusion: Inovare prosthesis, implanted by femoral or iliac artery was feasible, and determined adequate hemodynamic performance in the postoperative follow-up, showing no mortality in this small series.Descriptors: Heart valve diseases. Stents. Heart catheterization. Heart valve prosthesis implantation/methods. Aortic valve/surgery. ORIGINAL ARTICLE 209Rev Bras Cir Cardiovasc | Braz J Cardiovasc Surg Bras Cir Cardiovasc 2013;28(2):208- Rev INTRODUCTIONDegenerative calcification of normal or congenital bicuspid aortic valve is the leading cause of aortic valve stenosis in adults in developed countries [1][2][3]. Prevalence of severe aortic stenosis increases with age and may affect up to 2% of individuals over 65 years of age [4]. The onset of symptoms constitutes poor prognosis and survival after that is as low as 60% in 1 year and 32% in 5 years [5]. Death in patients with heart failure usually occurs 2 years after the onset of symptoms, and after 3 and 5 years for patients with syncope and angina, respectively [6]. In such cases, surgical intervention alters the natural course of the disease, since surgical mortality, at about 4%, is considered low [7]. However, 33% of patients who are candidates for surgical treatment are not accepted to undergo the procedure, especially due to advanced age and ventricular dysfunction [8]. Other conditions, such as associated comorbidit...

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Section: Discussionmentioning

confidence: 99%

Initial and pioneer experience of transcatheter aortic valve implantation (Inovare) through femoral or iliac artery

Pontes¹,

Duarte²,

Silva³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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“…In the multicentre United States registry cited above, 1-year mortality among inoperable patients was 24.3% [23]. Tamburino et al [10] found that at 1 year after TAVI, mortality in the log ES ≥ 20% group was 25.7% compared to 6.8% in the log ES < 20% group. In the study by Wenaweser et al [13], mortality at 1 year was 10.1% vs. 16.1% vs. 34.5%, respectively, in patients with STS score risk of < 3%, 3-8%, and > 8%.…”

Section: Long-term Outcomesmentioning

confidence: 97%

“…In several studies that included moderate risk patients, an association between log ES and 30-day mortality was found. In a study in 165 patients, Tamburino et al [10] found that 30-day mortality after TAVI was 15.6% in those with log ES ≥ 20% but much lower (2.4%) in those with log ES < 20%. Similar results were reported by Wenaweser et al [13] who divided 389 patients treated with TAVI into three groups depending on the operative risk by the STS risk score: low risk patients with STS < 3%, moderate risk patients with STS 3-8%, and high risk patients with STS > 8%.…”

Section: Immediate Outcomesmentioning

confidence: 98%

“…In previously published studies, TAVI outcomes were mostly compared between patients deemed not to be candidates for surgery due to log ES ≥ 20% or STS ≥ 10% and moderate risk patients (log ES < 20% or STS < 10%) [10][11][12][13]. In these reports, it has not been stated whether the patients with log ES < 20% were deemed not to be candidates for surgical treatment.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of mid-term results of transcatheter aortic valve implantation in high-risk patients with logistic EuroSCORE ≥ 20% or < 20%

et al. 2016

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A b s t r a c tBackground: Transcatheter aortic valve implantation (TAVI) is an established treatment method in selected high-risk patients with severe aortic stenosis. However, data on which patients gain most benefit from this procedure is still limited. According to the European consensus document, TAVI is recommended for high-risk patients with logistic EuroSCORE (log ES) ≥ 20%. To date, little is known about TAVI outcomes in patients with log ES < 20%. Aim:To evaluate outcomes of TAVI in high-risk patients with log ES ≥ 20% in comparison with high-risk patients with log ES < 20%. Methods and results:Of 93 patients who underwent TAVI at our institution between January 2009 and December 2011, we identified 59 (63.4%) patients with log ES ≥ 20% (Group 1) and 34 (36.6%) patients with log ES < 20% (Group 2). The mean log ES was 30.9 ± 9.7% in Group 1 and 12.7 ± 4.9% in Group 2 (p < 0.01). Significant differences were found between the two groups in regard to age (82.9 ± 5.9 vs. 78.7 ± 7.8 years, p = 0.001), left ventricular ejection fraction (51.5 ± 14% vs. 60.4 ± 9.6%, p = 0.002), pulmonary artery systolic pressure (56 ± 11 vs. 49 ± 10.6 mm Hg, p = 0.02), and glomerular filtration rate (51.3 ± 18.4 vs. 60.6 ± 16.6 mL/min/m 2 , p = 0.02). Survival rates at 1 and 2 years were 76.6% and 69.0% in Group 1 and 89.0% and 83.6% in Group 2 (p = NS). However, cardiovascular mortality at 1 and 2 years was higher in Group 1 compared to Group 2 (21.4% and 28.6% vs. 8.1% and 10.8% in Groups 1 and 2, respectively). Conclusions:The results of this study demonstrate that at 2 years of follow-up, TAVI in high-risk patients with log ES ≥ 20% was associated with a higher cardiovascular mortality compared to high-risk patients with log ES < 20%.

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“…Tamburino et al 120 found that the outcome of patients, principally treated with a CoreValve, who were at lower risk (logistic EuroSCORE [LES] <20%), is better than those at higher risk (30-day and 1-year mortality rate, 2.4% and 6.8% versus 15.6% and 25.7%). The rate of major adverse cardiovascular events was also lower at 30 days (6% versus 20.8%) and at 1 year (11.4% versus 27.1%).…”

Section: Other Observational Datamentioning

confidence: 99%

Transcatheter Aortic Valve Implantation in Lower-Risk Patients With Aortic Stenosis

Abdelghani

Serruys

2016

Circ: Cardiovascular Interventions

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Abstract-Transcatheter aortic valve implantation underwent progressive improvements until it became the default therapy for inoperable patients, and a recommended therapy in high-risk operable patients with symptomatic severe aortic stenosis. In the lower-risk patient strata, a currently costly therapy that still has important complications with questionable durability is competing with the established effective and still-improving surgical replacement. This report tries to weigh the clinical evidence, the recent technical improvements, the durability, and the cost-effectiveness claims supporting the adoption of transcatheter aortic valve implantation in intermediate-low risk patients. The importance of appropriate patients' risk stratification and a more comprehensive approach to estimate that risk are also emphasized in the present report. (Circ Cardiovasc Interv. 2016;9:e002944.

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Early‐ and mid‐term outcomes of transcatheter aortic valve implantation in patients with logistic EuroSCORE less than 20%: A comparative analysis between different risk strata

Abstract: This study tends to suggest that current mortality reported after TAVI could be significantly affected by the very-high risk profile of the population which currently undergoes this procedure, making comparison with surgical series rather unreliable.

Cited by 30 publications

References 24 publications

Initial and pioneer experience of transcatheter aortic valve implantation (Inovare) through femoral or iliac artery

Initial and pioneer experience of transcatheter aortic valve implantation (Inovare) through femoral or iliac artery

Comparison of mid-term results of transcatheter aortic valve implantation in high-risk patients with logistic EuroSCORE ≥ 20% or < 20%

Transcatheter Aortic Valve Implantation in Lower-Risk Patients With Aortic Stenosis

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