12 Clinical outcomes up to 10 years of asymptomatic incidental aortic dissections and large aortic aneurysms detected on computer tomography (CTA) prior to transcatheter aortic valve implantation (TAVI)

Abstract

management occurred in 46% of cases (n=96). Transferred patients were more likely to undergo operative management (OR 3.3 , 95% CI: 1.8, 5.8). Although men were more likely to undergo surgical management than women (OR 2.0, 95% CI: 1.1, 4.2), this is explained by women being six times more likely to be IVDUs (OR 6.1 CI: 2.3, 16.3) and have right-sided IE (OR 6.2 CI: 2.2, 17.4). When including only left-sided IE, the rate of surgery was not different between males and females (p=0.1). There was no difference in in-hospital or 12-month mortality in patients admitted directly to SCC and those referred (p=0.56) and there was no mortality difference between the sexes (p=0.20). In-hospital mortality of surgically managed patients was predicted by the Risk-E Score and EuroSCORE II as 18 and 12 cases respectively. We observed 11 in-hospital deaths. This difference was not significant (p=0.22). Transferred patients had a higher mean Risk-E Score (p<0.05) and a higher score was associated with a shorter time between diagnosis and surgery (p<0.05, figure 2). Conclusions There has been an increase in IE cases managed at the SCC over the last 5 years, with more transfers from other hospitals. This could be due to an increase in absolute IE numbers as well as better awareness of the need for early surgery and the involvement of an IE MDT. We report a previously unidentified male predominance in IE across all major organisms and a significant increase in oral streptococci infection; both require further exploration. In this population the Risk-E Score tended to overestimate in-hospital mortality. Larger multi-centre studies are required to explore these trends in sub-grouped populations.