Impact of right and left ventricular systolic dysfunction on perioperative outcome and long-term survival after transcatheter aortic valve replacement.
J Interv Cardiol
; 30(3): 217-225, 2017 Jun.
Article
em En
| MEDLINE
| ID: mdl-28439917
ABSTRACT
BACKGROUND:
Aim of the study was to determine the impact of right- and left-ventricular systolic dysfunction on perioperative outcome and long-term survival after TAVR.METHODS:
Study population consisted of 702 TAVRs between 2009 and 2014, 345 by TF, 357 by TA route. RV and LV function were determined by TAPSE and LVEF measurement during baseline echocardiography. Patients were divided according to TAPSE (>18 mm/14-18 mm/<14 mm) and LVEF (>50%/30-50%/<30%) tertiles. Outcome at day-30 and Kaplan-Meier 4-year survival were analyzed.RESULTS:
Impaired RV and LV-function did not adversely affect mortality, stroke, bleeding, and vascular-complications at 30 days. Patients with TAPSE < 14 mm displayed elevated rate of renal failure requiring dialysis (11%; P < 0.01). Kaplan-Meier survival was adversely affected by RV-systolic dysfunction RVSD (P < 0.01). Multivariate analysis revealed that impaired RVSD but not LVSD was an independent determinant for late mortality (hazard ratio TAPSE 14-18 mm 1.53; P = 0.02; TAPSE <14 mm 2.12; P < 0.01).CONCLUSIONS:
Peri-operative mortality and risk of stroke after TAVR are not adversely affected by preexisting RV or LV dysfunction. Long-term survival is impaired in patients with RVSD. RVSD but not LVSD is an independent risk factor for late mortality. TAVR should be the preferred therapy for patients with RVSD and LVSD, especially when patient is suitable for TF.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Estenose da Valva Aórtica
/
Disfunção Ventricular
/
Substituição da Valva Aórtica Transcateter
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
J Interv Cardiol
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Alemanha