Twelve-Month Quality of Life Improvement and All-Cause Mortality in Elderly Patients Undergoing Transcatheter Aortic Valve Replacement

Kleczyński, Paweł; Bagieński, Maciej; Dziewierz, Artur; Rzeszutko, Łukasz; Sorysz, Danuta; Trębacz, Jarosław; Sobczyński, Robert; Tomala, Marek; Stąpór, Maciej; Dudek, Dariusz

doi:10.5301/ijao.5000521

Cited by 18 publications

(17 citation statements)

References 22 publications

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“…TAVI improves survival and quality of life in inoperable patients as compared to medical treatment of severe AS [1][2][3]. However, post-implantation paravalvular leak (PVL) remains a significant TAVI-related complication [4].…”

Section: Introductionmentioning

confidence: 99%

Impact of post-dilatation on the reduction of paravalvular leak and mortality after transcatheter aortic valve implantation

Kleczyński¹,

Dziewierz²,

Daniec³

et al. 2017

Kardiol Pol

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A b s t r a c tBackground: Post-implantation paravalvular leak (PVL) remains a significant complication of transcatheter aortic valve implantation (TAVI). More importantly, its occurrence may impact long-term mortality. Aim:We sought to evaluate the effects of balloon post-dilatation (PD) on the reduction of PVL and mortality in patients undergoing TAVI.Methods: A total of 101 consecutive patients undergoing TAVI were enrolled. Angiography, echocardiography, and the aortic regurgitation index (ARI) were used to assess the severity of PVL before and after balloon PD. Patients were divided into two groups based whether or not PD after TAVI was performed. Reduction of PVL, change of ARI, and clinical outcomes were assessed.Results: Balloon post-dilatation was performed in 23 (22.8%) patients. In 95.6%, PVL reduction was successful (no or mild PVL). PD increased the ARI from 23.4% (22.4-24.0) to 27.1% (26.1-28.3); p < 0.001. Thirty-day mortality rate was 14.1% in the PD (-) group vs. 0.0% in the PD (+) group; p = 0.07. One-year mortality (21.8% vs. 4.3%, p = 0.97) and procedural stroke rate (7.7% vs. 8.7%, p = 0.99) were not different between the groups. Conclusions:Balloon post-dilatation may be a safe and effective technique to reduce moderate to severe PVL after TAVI.

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Section: Introductionmentioning

confidence: 99%

Impact of post-dilatation on the reduction of paravalvular leak and mortality after transcatheter aortic valve implantation

Kleczyński¹,

Dziewierz²,

Daniec³

et al. 2017

Kardiol Pol

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“…A complete description was reported previously [14]. We en rolled 148 consecutive patients who underwent TAVI.…”

Section: Methodsmentioning

confidence: 99%

Impact of previous cardiac surgery with sternotomy on clinical outcomes and quality of life after transcatheter aortic valve implantation for severe aortic stenosis

Tokarek¹,

Dziewierz²,

Bagieński³

et al. 2018

Kardiol Pol

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“…Symptomatic senile degenerative aortic stenosis (AS) leads to a progressive deterioration of quality of life and it is associated with an elevated mortality. 1 The most recent guidelines for the treatment of valvular heart disease identify the degenerative AS as the most common valve disease in Western countries, especially in the group aged over 65 years. 2 – 5 In its most severe form, AS represents a highly debilitating chronic disease characterized by symptoms such as precordial pain suggestive of angina, transient altered state of consciousness, or syncope, dyspnea and other heart failure symptoms secondary to a reduced stroke volume.…”

Section: Introductionmentioning

confidence: 99%

Possible predictive role of electrical risk score on transcatheter aortic valve replacement outcomes in older patients: preliminary data

Piccirillo¹,

Moscucci²,

Mastropietri³

et al. 2018

CIA

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ObjectivesTo evaluate the predicative power of the electrical risk score (ERS), a noninvasive and inexpensive test obtained by means of a standard 12-lead electrocardiogram (ECG), in a cohort of elderly patients who had undergone transcatheter aortic valve replacement (TAVR).MethodsSurvivors and non-survivors after TAVR at 1-year follow-up were compared in respect to the pre-procedural ERS as well as a number of other clinical and instrumental variables. ERS is composed of seven simple ECG markers: heart rate (>75 bpm); QRS duration (>110 ms); left ventricular hypertrophy (Sokolow–Lyon criteria); delayed QRS transition zone (≥ V4); frontal QRS-T angle (>90°); long QTBazett (>450 ms for men and >460 in women) or JTBazett (330 ms for men and >340 ms for women); and long Tpeak to Tend interval (Tp-e) (>89 ms). The trial was registered in ClinicalTrials.gov as NCT03145376.ResultsA total of 40 patients were evaluated. During the follow-up, the all-cause mortality rate was 25% (ten patients) with 15% of cardiovascular death (six patients). The ERS was the strongest predictor of all-cause (odds ratio 3.73, 95% CI: 1.44–9.66, P<0.05) or cardiovascular (odds ratio 3.95, 95% CI: 1.09–14.27, P<0.05) mortality. Receiver operating characteristic curves showed that ERS had the widest significant sensitivity-specificity area under the curve (AUC) predicting all-cause (AUC: 0.855, P<0.05) or cardiovascular mortality (AUC: 0.908, P<0.05).ConclusionERS seems to be a useful noninvasive tool able to stratify the risk of mortality in 1-year follow-up of TAVR patients. These findings, however, require larger trials to be confirmed.

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Twelve-Month Quality of Life Improvement and All-Cause Mortality in Elderly Patients Undergoing Transcatheter Aortic Valve Replacement

Abstract: TAVI provides improved QoL with relatively good clinical outcomes. However, not all components of QoL may be improved. Patients treated with transfemoral access might have better QoL than those who had non-transfemoral access, especially early after TAVI.

Cited by 18 publications

References 22 publications

Impact of post-dilatation on the reduction of paravalvular leak and mortality after transcatheter aortic valve implantation

Impact of post-dilatation on the reduction of paravalvular leak and mortality after transcatheter aortic valve implantation

Impact of previous cardiac surgery with sternotomy on clinical outcomes and quality of life after transcatheter aortic valve implantation for severe aortic stenosis

Possible predictive role of electrical risk score on transcatheter aortic valve replacement outcomes in older patients: preliminary data

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