In-hospital outcomes of transcatheter versus surgical aortic valve replacement for nonagenarians.
Catheter Cardiovasc Interv
; 93(5): 989-995, 2019 04 01.
Article
em En
| MEDLINE
| ID: mdl-30569661
ABSTRACT
OBJECTIVES:
To compare the in-hospital outcomes of transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in nonagenarians.BACKGROUND:
Data comparing the outcomes of TAVR versus SAVR in nonagenarians are limited.METHODS:
Using the National Inpatient Sample years 2012-2014, hospitalization data were retrieved for subjects aged ≥90 years who underwent TAVR or SAVR for severe aortic stenosis. The incidence of in-hospital mortality and peri-procedural outcomes were compared using unadjusted, multivariate logistic regression, and propensity score matched analyses.RESULTS:
The final cohort included 6,680 records of nonagenarians undergoing aortic valve replacement, among which 5,840 (87.4%) underwent TAVR. There was no difference in the incidence of in-hospital mortality between both groups in the unadjusted (5.8% versus 6.0% P = 0.95), multivariate (odds ratio [OR] 0.78, 95% confidence interval [CI] 0.35-1.74), and propensity score matched (OR 1.07, 95% CI 0.75-1.51) analyses. In the propensity-matched analysis, TAVR was associated with a lower incidence of acute kidney injury (OR 0.58, 95% CI 0.47-0.72), post-operative blood transfusion (OR 0.51, 95% CI 0.43-0.61), a higher likelihood of discharge to home (OR 4.71, 95% 3.44-5.06), and a similar incidence of pacemaker placement (OR 1.16, 95% 0.89-1.53) and stroke (OR 1.34, 0.90-1.99).CONCLUSIONS:
In this nationwide analysis, TAVR was associated with an overall similar incidence of in-hospital mortality and less morbidity compared with SAVR. These findings suggest that TAVR is effective and safe in nonagenarians.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Valva Aórtica
/
Estenose da Valva Aórtica
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Implante de Prótese de Valva Cardíaca
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Substituição da Valva Aórtica Transcateter
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged80
/
Female
/
Humans
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Catheter Cardiovasc Interv
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article