TAVI in Patients with Mitral Annular Calcification and/or Mitral Stenosis.
Thorac Cardiovasc Surg
; 69(5): 428-436, 2021 Aug.
Article
en En
| MEDLINE
| ID: mdl-32114689
ABSTRACT
BACKGROUND:
We herein aimed for analysis of influence of mitral annular calcification (MAC) and mitral stenosis (MS) on outcomes in transcatheter aortic valve implantation (TAVI).METHODS:
Between 11/2009 and 06/2017, 1,058 patients underwent TAVI in the presence of concomitant MAC or MS at our center. Subgroups were built and multivariate logistic regression, COX regression, Kaplan-Meier survival analyses, and receiver operating characteristics method were performed.RESULTS:
Thirty-day mortality was 7.5% (79/1,058) with highest mortality in patients severe MS (MAC 3.4% vs. mild MS 5.9% vs. moderate MS 15.0% vs. severe MS 72.7%; p < 0.001). Moderate-to-severe MS (odds ratio [OR] 7.75, confidence interval [CI] 3.94-16.26, p < 0.001), impaired left ventricular ejection fraction (OR 1.38, CI 1.10-1.72, p < 0.01), and coronary artery disease (OR 1.36, CI 1.11-1.67, p < 0.01) were predictive of 30-day survival. Left ventricular systolic/end-diastolic pressure drop of <59.5 mm Hg / <19.5 mm Hg was associated with increased mortality.CONCLUSIONS:
TAVI in the presence of MAC and mild MS is associated with acceptable acute outcomes but should be considered high-risk procedures in patients with moderate and especially those with severe MS. Our results suggest adverse hemodynamics after TAVI with concomitant MS, which may be caused by underfilling of the left ventricle leading to low-cardiac output.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Válvula Aórtica
/
Estenosis de la Válvula Aórtica
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Calcinosis
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Reemplazo de la Válvula Aórtica Transcatéter
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Hemodinámica
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Válvula Mitral
/
Estenosis de la Válvula Mitral
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
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Aged80
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Female
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Humans
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Male
Idioma:
En
Año:
2021
Tipo del documento:
Article