TY  - BOOK
AU  - Baker, Nevin C
AU  - Ben-Dor, Itsik
AU  - Chen, Fang
AU  - Corso, Paul J
AU  - Escarcega, Ricardo O
AU  - Lipinski, Michael J
AU  - Magalhaes, Marco A
AU  - Minha, Sa'ar
AU  - Pichard, Augusto D
AU  - Satler, Lowell F
AU  - Torguson, Rebecca
AU  - Waksman, Ron
TI  - Analysis of long-term survival following transcatheter aortic valve implantation from a single high-volume center
SN  - 0002-9149
KW  - *Aortic Valve Stenosis/su [Surgery]
KW  - *Hospitals, High-Volume/sn [Statistics & Numerical Data]
KW  - *Transcatheter Aortic Valve Replacement/mo [Mortality]
KW  - Aged, 80 and over
KW  - Aortic Valve Stenosis/mo [Mortality]
KW  - District of Columbia/ep [Epidemiology]
KW  - Female
KW  - Follow-Up Studies
KW  - Humans
KW  - Male
KW  - Postoperative Period
KW  - Prognosis
KW  - Retrospective Studies
KW  - Survival Rate/td [Trends]
KW  - Time Factors
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - Mortality after transcatheter aortic valve implantation (TAVI) has been reported to range up to 3 years. However, long-term mortality remains underexplored. The aims of this study were to determine long-term mortality in patients who undergo TAVI and to identify correlates of long-term death. From a single institution's prospectively collected TAVI database, all patients who underwent TAVI with a maximum follow-up duration of 5 years were analyzed. The population was analyzed on the basis of access route (transapical TAVI or transfemoral TAVI). Cox regression and Kaplan-Meier survival analysis were conducted. A total of 511 patients who underwent TAVI were included in the analysis (transapical TAVI n = 115, transfemoral TAVI n = 396). The mean Society of Thoracic Surgeons score was 9.6 +/- 4. Mortality at 30 days (18% vs 6%, p <0.001) and 1 year (32% vs 21%, p <0.01) was significantly increased in the transapical TAVI group. Long-term survival probability was <50% for the 2 approaches (log-rank p = 0.33). Vascular complications (hazard ratio [HR] 2.14, 95% confidence interval [CI] 1.38 to 3.33, p = 0.001), more than mild aortic insufficiency (HR 1.81, 95% CI 1.15 to 2.83, p = 0.01), atrial fibrillation (HR 1.87, 95% CI 1.36 to 2.57, p <0.001), and in-hospital stroke (HR 2.35, 95% CI 1.39 to 4.00, p = 0.002) were independently associated with long-term death. The survival probability of patients at high surgical risk versus those who were inoperable was similar in the long term (log-rank p = 0.53). In conclusion, the overall long-term survival of patients with aortic stenosis who were approved to undergo TAVI was <50% irrespective of access method. Strategies geared toward reducing in-hospital stroke, vascular complications, and aortic regurgitation are still needed, as these variables are correlates of long-term mortality.Copyright � 2015 Elsevier Inc. All rights reserved
UR  - http://dx.doi.org/10.1016/j.amjcard.2015.04.016
ER  -