Does the disparity in baseline characteristics of patients undergoing transcatheter aortic valve replacement with 23 mm vs. 26 mm valves impact clinical outcome?. 

 -  2016 
<br/><br/>Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006 
<br/><br/> BACKGROUND: Transcatheter aortic valve replacement (TAVR) is currently an approved therapy for patients with severe aortic stenosis who are considered inoperable or are at high risk.  CONCLUSION: Patients undergoing TAVR with 23 and 26 mm valves have similar clinical outcomes despite significant differences in baseline characteristics. © 2015 Wiley Periodicals, Inc.  Copyright © 2015 Wiley Periodicals, Inc.  METHODS: We retrospectively examined baseline characteristics and outcomes of patients receiving a 23 mm (n=132) vs. 26 mm valve (n=81) via the transfemoral approach.  OBJECTIVES: We sought to identify if baseline characteristic differences in patients who receive a 23 mm vs. 26 mm valve impact clinical outcomes.  RESULTS: Gender (P<0.01), previous coronary artery bypass surgery (P<0.01), history of atrial fibrillation (P=0.04), and mean Society of Thoracic Surgeons (STS) score (P<0.01) were significantly different between groups. There were no significant differences in the rates of minor/major vascular complications (2.2 vs. 3.7%, P=0.68 and 13.0 vs. 12.3%, P=0.89, respectively). Bleeding complications were also comparable (major bleed 2.3 vs. 1%, P >0.99, minor bleed 19.0 vs. 22.0%, P=0.67 and life threatening bleed 7.0 vs. 5.0%, P=0.77). In-hospital death (6.0 vs. 5.0%, P >0.99), 30-day all-cause death (7.6 vs. 6.2%, P=0.69), and all-cause death at 1 year (17.4 vs. 25.9%, P=0.13) were also similar between groups. Gender, valve size, previous coronary bypass surgery and atrial fibrillation were not independently associated with mortality; however, on multivariate analysis STS score was (HR 1.11; 95% CI 1.02-1.19; P=0.01). 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>1522-1946 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Aortic Valve Stenosis/su [Surgery]<br/>*Aortic Valve/su [Surgery]<br/>*Transcatheter Aortic Valve Replacement/mt [Methods]<br/>Aged, 80 and over<br/>Aortic Valve Stenosis/di [Diagnosis]<br/>Aortic Valve/dg [Diagnostic Imaging]<br/>Female<br/>Follow-Up Studies<br/>Humans<br/>Male<br/>Prosthesis Design<br/>Retrospective Studies<br/>Severity of Illness Index<br/>Tomography, X-Ray Computed<br/>Treatment Outcome
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Heart & Vascular Institute
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article