Does the disparity in baseline characteristics of patients undergoing transcatheter aortic valve replacement with 23 mm vs. 26 mm valves impact clinical outcome?.
Does the disparity in baseline characteristics of patients undergoing transcatheter aortic valve replacement with 23 mm vs. 26 mm valves impact clinical outcome?.
- 2016
Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006
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).
English
1522-1946
*Aortic Valve Stenosis/su [Surgery]
*Aortic Valve/su [Surgery]
*Transcatheter Aortic Valve Replacement/mt [Methods]
Aged, 80 and over
Aortic Valve Stenosis/di [Diagnosis]
Aortic Valve/dg [Diagnostic Imaging]
Female
Follow-Up Studies
Humans
Male
Prosthesis Design
Retrospective Studies
Severity of Illness Index
Tomography, X-Ray Computed
Treatment Outcome
MedStar Heart & Vascular Institute
Journal Article
Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006
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).
English
1522-1946
*Aortic Valve Stenosis/su [Surgery]
*Aortic Valve/su [Surgery]
*Transcatheter Aortic Valve Replacement/mt [Methods]
Aged, 80 and over
Aortic Valve Stenosis/di [Diagnosis]
Aortic Valve/dg [Diagnostic Imaging]
Female
Follow-Up Studies
Humans
Male
Prosthesis Design
Retrospective Studies
Severity of Illness Index
Tomography, X-Ray Computed
Treatment Outcome
MedStar Heart & Vascular Institute
Journal Article