MedStar Authors catalog › Details for: Impact of previous coronary artery bypass grafting on patients undergoing transcatheter aortic valve implantation for aortic stenosis.
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Impact of previous coronary artery bypass grafting on patients undergoing transcatheter aortic valve implantation for aortic stenosis.

by Minha, Sa'ar; Magalhaes, Marco A; Barbash, Israel M; Ben-Dor, Itsik; Dvir, Danny; Okubagzi, Petros; Chen, Fang; Torguson, Rebecca; Kent, Kenneth M; Suddath, William O; Satler, Lowell F; Pichard, Augusto D; Waksman, Ron.
Citation: American Journal of Cardiology. 113(7):1222-7, 2014 Apr 1..Journal: The American journal of cardiology.ISSN: 0002-9149.Full author list: Minha S; Magalhaes MA; Barbash IM; Ben-Dor I; Dvir D; Okubagzi PG; Chen F; Torguson R; Kent KM; Suddath WO; Satler LF; Pichard AD; Waksman R.UI/PMID: 24513466.Subject(s): Aged, 80 and over | Aortic Valve Stenosis/co [Complications] | Aortic Valve Stenosis/mo [Mortality] | *Aortic Valve Stenosis/su [Surgery] | *Cardiac Catheterization/mt [Methods] | *Coronary Artery Bypass | District of Columbia/ep [Epidemiology] | Female | Follow-Up Studies | *Heart Valve Prosthesis Implantation/mt [Methods] | Humans | Male | Myocardial Ischemia/co [Complications] | Myocardial Ischemia/mo [Mortality] | *Myocardial Ischemia/su [Surgery] | Prognosis | Reoperation | Retrospective Studies | *Risk Assessment/mt [Methods] | Risk Factors | Survival Rate/td [Trends]Institution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: http://dx.doi.org/10.1016/j.amjcard.2013.12.029 (Click here) Abbreviated citation: Am J Cardiol. 113(7):1222-7, 2014 Apr 1.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006.Abstract: Re-operation after coronary artery bypass grafting (CABG) is associated with increased risk for morbidity and mortality. Transcatheter aortic valve implantation (TAVI) is an alternative for patients with aortic stenosis, but the outcomes of patients with a history of CABG are unknown. The aim of this study was to explore the association between previous CABG and the outcome of patients undergoing TAVI. Out of 372 consecutive patients who underwent TAVI from 2007 to 2013, 122 (32.8%) had previous CABG, whereas 250 (67.2%) did not. A comparison was made between groups. Subgroup analysis compared patients with and without previous CABG in 3 patient subsets: inoperable, operable, and those who underwent transapical TAVI. Patients with previous CABG were younger (81.99+6.78 vs 84.81+7.06 years, respectively, p<0.001). These patients also had more high-risk features (e.g., peripheral vascular disease, previous myocardial infarction, past cerebrovascular disease, and lower average left ventricular ejection fraction (p<0.05 for all). Procedural aspects were mostly similar between groups. No disparities in mortality rates at 1 year were noted (22.1% vs 21.6%, respectively, p=0.91). Subgroup analyses yielded similar outcomes for all 3 groups. In conclusion, although patients with previous CABG present with more high-risk features, they share similar short- and long-term outcomes with patients without previous CABG, irrespective of their surgical risk. This includes patients who underwent transapical access. TAVI in patients with previous CABG is safe and does not confer a significant risk for adverse outcome. Copyright 2014 Elsevier Inc. All rights reserved.

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