Five-year follow-up after transcatheter aortic valve implantation for symptomatic aortic stenosis

Zahn, Ralf; Werner, Nicolas; Gerckens, Ulrich; Linke, Axel; Sievert, Horst; Hambrecht, Rainer; Sack, Stefan; Abdel‐Wahab, Mohamed; Hoffmann, Ellen; Zeymer, Uwe; Schneider, Steffen

doi:10.1136/heartjnl-2016-311004

Cited by 28 publications

(40 citation statements)

References 33 publications

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“…The effect of ICR on mortality is similar if not greater to that of well-recognized mortality predictors post-TAVR (as reported recently in a 5-year follow-up results of a large national all comers TAVR registry), such as frailty, residual moderate+aortic regurgitation, renal failure, low valve gradients pre-TAVR, and atrial fibrillation, 29 but unlike these factors, the level of revascularization completeness is, at least potentially, modifiable. Our results suggest that adequate revascularization pre-TAVR may offer a unique and significant opportunity to improve the prognosis of patients with CAD undergoing TAVR-a finding that is relevant to ≈50% of TAVR patients.…”

Section: Discussionsupporting

confidence: 76%

Impact of Coronary Artery Revascularization Completeness on Outcomes of Patients With Coronary Artery Disease Undergoing Transcatheter Aortic Valve Replacement

Witberg

Zusman

Codner

et al. 2018

Circ: Cardiovascular Interventions

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Background-Coronary artery disease (CAD) is highly prevalent in patients undergoing transcatheter aortic valve replacement.In the overall CAD population, complete revascularization or reasonable incomplete revascularization (ICR) is associated with improved outcomes; whether the same applies for the transcatheter aortic valve replacement population is still a matter of debate. Methods and Results-We conducted a systematic review and meta-analysis of studies that examined the prognostic effect of revascularization completeness in patients undergoing transcatheter aortic valve replacement using the residual SYNTAX score (Synergy Between PCI With Taxus and Cardiac Surgery) to separate between reasonable ICR and ICR (using the individual threshold used by each study). Six studies with a total of 3107 patients were included. The duration of follow-up ranged from 0.7 to 3 years. Overall, ICR was associated with an increased risk for mortality. This was true when comparing ICR patients to those with no CAD (odds ratio,

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Section: Discussionsupporting

confidence: 76%

Impact of Coronary Artery Revascularization Completeness on Outcomes of Patients With Coronary Artery Disease Undergoing Transcatheter Aortic Valve Replacement

Witberg

Zusman

Codner

et al. 2018

Circ: Cardiovascular Interventions

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“…Among them, 4 were excluded because they did not report multivariable adjustment or midterm follow-up [15][16][17]24]. Finally, 6 studies were included, 5 [10][11][12][13][14] deriving from published articles and 1 from a congress abstract [14].…”

Section: Study Selectionmentioning

confidence: 99%

“…In this setting, the effect of gender may be relevant to understand timing and opportunity of percutaneous intervention, but only a limited number of studies, reporting variable results, have investigated genderspecific differences in outcome after TAVI [9][10][11][12][13][14][15][16][17]. A recent meta-analysis on the same topic reported better short-term and midterm survival for women.…”

mentioning

confidence: 98%

Effect of Gender After Transcatheter Aortic Valve Implantation: A Meta-Analysis

Conrotto

D’Ascenzo

Presbitero

et al. 2015

The Annals of Thoracic Surgery

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“…Due to the demographic shift and the aging population, the prevalence of aortic stenosis (AS) as the most frequent valve disease is enhancing [1]. For patients having a prohibitive surgical risk, transcatheter aortic valve implantation (TAVI) has been developed as an alternative to the surgical valve replacement.…”

Section: Introductionmentioning

confidence: 99%

Geriatric or cardiac rehabilitation? Predictors of treatment pathways in advanced age patients after transcatheter aortic valve implantation

Eichler

Völler

Reibis³

et al. 2020

BMC Cardiovasc Disord

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Background: Aim of the study was to find predictors of allocating patients after transcatheter aortic valve implantation (TAVI) to geriatric (GR) or cardiac rehabilitation (CR) and describe this new patient group based on a differentiated characterization.Methods: From 10/2013 to 07/2015, 344 patients with an elective TAVI were consecutively enrolled in this prospective multicentric cohort study. Before intervention, sociodemographic parameters, echocardiographic data, comorbidities, 6-min walk distance (6MWD), quality of life and frailty (score indexing activities of daily living [ADL], cognition, nutrition and mobility) were documented. Out of these, predictors for assignment to CR or GR after TAVI were identified using a multivariable regression model.Results: After TAVI, 249 patients (80.7 ± 5.1 years, 59.0% female) underwent CR (n = 198) or GR (n = 51). GR patients were older, less physically active and more often had a level of care, peripheral artery disease as well as a lower left ventricular ejection fraction. The groups also varied in 6MWD. Furthermore, individual components of frailty revealed prognostic impact: higher values in instrumental ADL reduced the probability for referral to GR (OR:0.49, p < 0.001), while an impaired mobility was positively associated with referral to GR (OR:3.97, p = 0.046). Clinical parameters like stroke (OR:0.19 of GR, p = 0.038) and the EuroSCORE (OR:1.04 of GR, p = 0.026) were also predictive.Conclusion: Advanced age patients after TAVI referred to CR or GR differ in several parameters and seem to be different patient groups with specific needs, e.g. regarding activities of daily living and mobility. Thus, our data prove the eligibility of both CR and GR settings.

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Five-year follow-up after transcatheter aortic valve implantation for symptomatic aortic stenosis

Abstract: These data from the early TAVI experience show a 5-year mortality of 59.1%. Some of the predictors of 5-year mortality seem to be modifiable, such as residual aortic regurgitation, type of TAVI access route and concomitant mitral regurgitation.

Cited by 28 publications

References 33 publications

Impact of Coronary Artery Revascularization Completeness on Outcomes of Patients With Coronary Artery Disease Undergoing Transcatheter Aortic Valve Replacement

Impact of Coronary Artery Revascularization Completeness on Outcomes of Patients With Coronary Artery Disease Undergoing Transcatheter Aortic Valve Replacement

Effect of Gender After Transcatheter Aortic Valve Implantation: A Meta-Analysis

Geriatric or cardiac rehabilitation? Predictors of treatment pathways in advanced age patients after transcatheter aortic valve implantation

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