Impact of previous acute pulmonary oedema after transcatheter aortic valve implantation: Insight from French Aortic National CoreValve and Edwards 2 [FRANCE 2]registry

Furuta, Akira; Lellouche, Nicolas; Mouillet, Gauthier; Gilard, Martine; Laskar, Marc; Eltchaninoff, Hélène; Fajadet, Jean; Iung, Bernard; Donzeau–Gouge, Patrick; Leprince, Pascal; Leuguerrier, Alain; Prat, Alain; Dubois‐Randé, Jean‐Luc; Teiger, Emmanuel

doi:10.1016/j.ijcard.2015.01.037

Cited by 5 publications

(3 citation statements)

References 20 publications

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“…Considering that our patients underwent CGA because they were presumed frail and unsuitable for TAVI, it is noticeable that this 16% 1-year mortality remains comparable with the 21.4–24% reported by the largest national TAVI registries [ 11 , 23 ]. Beyond the TAVI procedure by itself, 1-year mortality predictors were history of pulmonary edema or moderate renal failure, as previously reported by others [ 24 , 25 ], but none of the CGA parameters ( Table III ).…”

Section: Discussionsupporting

confidence: 75%

Prognostic value of a comprehensive geriatric assessment for predicting one-year mortality in presumably frail patient with symptomatic aortic stenosis

et al. 2021

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IntroductionDespite of suffering a severe aortic stenosis, some patients are denied from either surgical or Transcatheter Aortic Valve Implantation (TAVI) therapy because of a frail condition. We aim to identify whether a comprehensive geriatric assessment (CGA) might be useful to predict prognosis of presumably frail patients with severe aortic stenosis.Material and methodsBetween March 2011 and July 2016, 818 patients were consecutively and prospectively enrolled. 161 had a CGA and were considered for analysis. Considering combined CGA and Heart team recommendations, 102 TAVI were performed (TAVI group) and 59 patients constituted the no TAVI group. Primary endpoint was all-cause mortality at one year.ResultsThere was no difference between the TAVI and the no TAVI groups considering morphometric data, cardiovascular risk factors or symptoms. The no TAVI group had higher surgical risk (logistic EuroSCORE1 33.4±17.8 vs. 22.7±14.9; p<0.001) and more moderate renal insufficiency (82% vs. 57%; p=0.001). One-year mortality was 16% in the TAVI group and 46% in the no TAVI group (p<0.001). Multivariate analysis revealed history of pulmonary edema, moderate renal failure, and not having a TAVI, to relate to 1-year mortality. There was an interaction of the Five-Times-Sit-to-Stand-Test (FTSST) upon the effect of TAVI on mortality (p=0.049), as FTSST was the only predictor for 1-year mortality in the no TAVI group (HR:0.18 95%CI 0.04–0.76; p=0.019).ConclusionsOne-year mortality was higher in geriatric-assessed frail patient who did not undergo TAVI. FTSST, which assesses patients’ mobility, was the only prognostic marker for 1-year mortality, on top of usual medical parameters.

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Section: Discussionsupporting

confidence: 75%

Prognostic value of a comprehensive geriatric assessment for predicting one-year mortality in presumably frail patient with symptomatic aortic stenosis

et al. 2021

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“…In the large German Aortic Valve Registry (GARY) registry reflecting real-world conditions, inhouse mortality was 5.2% 11. However, in the instance of aortic decompensation and shock, the prognosis worsens rapidly, amounting to 16% after more than one episode of pulmonary oedema12 and up to 33% in a recent study of 27 eTAVIs 13. Similarly, BAV, a procedure reportedly yielding 3.5%14 to 6.5%15 30-day mortality rates in elderly elective cases, rapidly progresses to 15% in a cohort with 7.5% shock patients16 or to ca.…”

Section: Discussionmentioning

confidence: 99%

Emergency treatment of decompensated aortic stenosis

Bongiovanni

Kühl

Bleiziffer

et al. 2017

Heart

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ObjectiveThe optimal treatment of patients with acute and severe decompensation of aortic stenosis is unclear due to recent advances in transcatheter interventions and supportive therapies. Our aim was to assess the early outcome of emergency transcatheter aortic valve implantation (eTAVI) versus emergency balloon aortic valvuloplasty (eBAV) followed by TAVI under elective circumstances.MethodsEmergency conditions were defined as: cardiogenic shock with requirement of catecholamine therapy, severe acute dyspnoea (NYHA IV), cardiac resuscitation or mechanic respiratory support. The data were collected according to the Valve Academic Research Consortium 2 (VARC-2) criteria.ResultsIn five German centres, 23 patients (logistic Euroscore 37.7%±18.1) underwent eTAVI and 118 patients underwent eBAV (logistic Euroscore 35.3%±20.8). In the eTAVI group, immediate procedural mortality was 8.7%, compared with 20.3% for the eBAV group (p=0.19). After 30 days, cardiovascular mortality for the eTAVI group was 23.8% and for the eBAV group 33.0% (p=0.40). Analyses adjusting for potential confounders did not provide evidence of a difference between groups. Of note, the elective TAVI performed after eBAV (n=32, logistic Euroscore 25.9%±13.9) displayed an immediate procedural mortality of 9.4% and a cardiovascular mortality after 30 days of 15.6%. Major vascular complications were significantly more likely to occur after eTAVI (p=0.01) as well as stroke (p=0.01).ConclusionIn this multicentre cohort, immediate procedural and 30-day mortality of eTAVI and eBAV were high, and mortality of secondary TAVI subsequent to eBAV was higher than expected. Randomised study data are required to define the role of emergency TAVI in tertiary care centres with current device generations.

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“…However, the definition of COPD in these included studies was somewhat vague. Because of poorer heart function and pulmonary edema , pulmonary function testing may overestimate the grade of COPD . Additional studies are needed that focus on the definition and grade classification of COPD.…”

Section: Discussionmentioning

confidence: 99%

The relationship between chronic obstructive pulmonary disease and transcatheter aortic valve implantation—A systematic review and meta‐analysis

Liao

Zhang

et al. 2016

Cathet Cardio Intervent

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Impact of previous acute pulmonary oedema after transcatheter aortic valve implantation: Insight from French Aortic National CoreValve and Edwards 2 [FRANCE 2]registry

Cited by 5 publications

References 20 publications

Prognostic value of a comprehensive geriatric assessment for predicting one-year mortality in presumably frail patient with symptomatic aortic stenosis

Prognostic value of a comprehensive geriatric assessment for predicting one-year mortality in presumably frail patient with symptomatic aortic stenosis

Emergency treatment of decompensated aortic stenosis

The relationship between chronic obstructive pulmonary disease and transcatheter aortic valve implantation—A systematic review and meta‐analysis

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