MedStar Authors catalog › Details for: The Association of Tricuspid Regurgitation With Transcatheter Aortic Valve Replacement Outcomes: A Report From The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.
The Association of Tricuspid Regurgitation With Transcatheter Aortic Valve Replacement Outcomes: A Report From The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.
Citation: Annals of Thoracic Surgery. 105(4):1121-1128, 2018 04..Journal: The Annals of thoracic surgery.Published: 2018ISSN: 0003-4975.Full author list: McCarthy FH; Vemulapalli S; Li Z; Thourani V; Matsouaka RA; Desai ND; Kirtane A; Anwaruddin S; Williams ML; Giri J; Vallabhajosyula P; Li RH; Herrmann HC; Bavaria JE; Szeto WY.UI/PMID: 29502934.Subject(s): Aged | Aged, 80 and over | *Aortic Valve Stenosis/co [Complications] | *Aortic Valve Stenosis/su [Surgery] | Female | Heart Failure/ep [Epidemiology] | Hospitalization/sn [Statistics & Numerical Data] | Humans | Male | Registries | Retrospective Studies | *Transcatheter Aortic Valve Replacement/ae [Adverse Effects] | Treatment Outcome | *Tricuspid Valve Insufficiency/co [Complications] | Tricuspid Valve Insufficiency/di [Diagnosis] | United StatesInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access onlineDigital Object Identifier: https://dx.doi.org/10.1016/j.athoracsur.2017.11.018 (Click here)Abbreviated citation: Ann Thorac Surg. 105(4):1121-1128, 2018 04.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007.Abstract: BACKGROUND: The purpose of this study is to evaluate the association of tricuspid regurgitation (TR) severity with outcomes after transcatheter aortic valve replacement (TAVR).Abstract: METHODS: We analyzed data from 34,576 patients who underwent TAVR at 365 US hospitals from November 2011 through March 2015 submitted to The Society of Thoracic Surgeon/American College of Cardiology Transcatheter Valve Therapy Registry. We examined unadjusted mortality and heart failure readmission stratified by degree of preoperative TR and used multivariable models for 1-year mortality and heart failure readmission.Abstract: RESULTS: Tricuspid regurgitation was present in 80% (n = 27,804) of TAVR patients, with mild TR in 56% (n = 19,393), moderate TR in 19% (n = 6687), and severe TR in 5% (n = 1,724). Increasing TR severity was associated with a number of comorbidities and The Society of Thoracic Surgeons predicted risk of mortality increased (p < 0.001): no TR (7.3 +/- 5.4); mild TR (8.0 +/- 5.7); moderate TR (9.6 +/- 6.8); and severe TR (10.7 +/- 7.4). In unadjusted analysis, moderate and severe TR were associated with increased use of cardiopulmonary bypass, longer intensive care unit and hospital stays, new dialysis, inhospital major adverse cardiac event, inhospital mortality, observed-to-expected inhospital mortality ratio, long-term heart failure readmission, and mortality (p < 0.001). Adjusted mortality at 1 year was significantly worse for patients with severe TR when left ventricular ejection fraction greater than 30% (hazard ratio 1.29, 95% confidence interval: 1.11 to 1.50) as was heart failure readmission (hazard ratio 1.27, 95% confidence interval: 1.04 to 1.54).Abstract: CONCLUSIONS: Tricuspid regurgitation was common among patients undergoing TAVR. Increasing TR severity was associated with higher risk patients and increased mortality and readmission-particularly for patients with severe TR and left ventricular ejection fraction greater than 30%. The effectiveness of TAVR alone in patients with aortic stenosis and concomitant severe TR may warrant further consideration, particularly for lower risk patients.Abstract: Copyright (c) 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.