Outcomes and Predictors of Mortality AfterTranscatheter Aortic Valve Implantation: results of theBrazilian Registry
Catheter. cardiovasc. interv
; 85: E153-E162, 2015. ilus
Article
in English
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1061884
Responsible library:
BR79.1
Localization: BR79.1
ABSTRACT
The study sought to evaluate outcomes and predictors of mortality after transcatheteraortic valve implantation (TAVI). Background:
TAVI registries can reliablyaddress outcomes and issues that adversely affect results in real-life.Methods:
Allendpoints and complications were analyzed according to Valve Academic ResearchConsortium-2 criteria.Results:
Between January 2008 and January 2013, 418 patientsunderwent TAVI in 18 centers and were included in the Brazilian registry. The transfemoralapproach was used in 96.2% of the procedures. The CoreValve and Sapien XTprosthesis were used in 360 (86.1%) and 58 (13.9%) cases, respectively. All-cause mortalityat 30 days and 1 year were 9.1 and 21.5%. Chronic obstructive pulmonary disease(COPD) (HR 3.50), acute kidney injury (AKI) (HR 3.07), stroke (HR 2.71) and moderate/severe paravalvular regurgitation (PVR) (HR 2.76) emerged as independent predictors ofoverall mortality. COPD (OR 3.00), major vascular complications (OR 7.99) and devicemalpositioning (OR 6.97) were predictors of early ( 30 days) mortality, while COPD (HR2.68), NYHA class III/IV (HR 3.04), stroke (HR 4.15), AKI (HR 2.44) and moderate/severePVR (HR 3.20) impacted late (>30 days) mortality. The use of transesophageal echocardiogram(TEE) to monitor the procedure was found to be a protective factor againstoverall (HR 0.57) and late (HR 0.47) mortality.Conclusion:
This multicenter registryreflected a real-life national TAVI experience. Comorbidities, periprocedural complicationsand moderate/severe PVR were associated with increased mortality and the useof TEE to monitor the procedure acted as a protective factor.
Search on Google
Collection:
National databases
/
Brazil
Database:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Echocardiography
/
Heart Valve Prosthesis Implantation
/
Acute Kidney Injury
Type of study:
Controlled clinical trial
/
Prognostic study
/
Risk factors
Language:
English
Journal:
Catheter. cardiovasc. interv
Year:
2015
Document type:
Article
Institution/Affiliation country:
Hospital Beneficencia Portuguesa/BR
/
Hospital Israelita Albert Einstein/BR
/
Hospital Oswaldo Cruz/BR
/
Hospital Pro Cardiaco/BR
/
Hospital S O S Cardio/BR
/
Instituto Dante Pazzanese de Cardiologia/BR
/
Instituto Nacional de Cardiologia/BR
/
Instituto de Cardiologia/BR
/
Instituto do Coração/BR
/
Pontificia Universidade Cat olica/BR