TY  - BOOK
AU  - Asch, Federico M
AU  - Ben-Dor, Itsik
AU  - Buchanan, Kyle
AU  - Koifman, Edward
AU  - Okubagzi, Petros
AU  - Pichard, Augusto D
AU  - Rogers, Toby
AU  - Satler, Lowell F
AU  - Shults, Christian
AU  - Steinvil, Arie
AU  - Torguson, Rebecca
AU  - Waksman, Ron
AU  - Xu, Linzhi
TI  - Role of contractile reserve as a predictor of mortality in low-flow, low-gradient severe aortic stenosis following transcatheter aortic valve replacement
SN  - 1522-1946
PY  - 2019///
KW  - *Aortic Valve Stenosis/su [Surgery]
KW  - *Aortic Valve/su [Surgery]
KW  - *Hemodynamics
KW  - *Myocardial Contraction
KW  - *Transcatheter Aortic Valve Replacement/mo [Mortality]
KW  - *Ventricular Dysfunction, Left/pp [Physiopathology]
KW  - *Ventricular Function, Left
KW  - Aged
KW  - Aged, 80 and over
KW  - Aortic Valve Stenosis/dg [Diagnostic Imaging]
KW  - Aortic Valve Stenosis/mo [Mortality]
KW  - Aortic Valve Stenosis/pp [Physiopathology]
KW  - Aortic Valve/dg [Diagnostic Imaging]
KW  - Aortic Valve/pp [Physiopathology]
KW  - Databases, Factual
KW  - Female
KW  - Humans
KW  - Male
KW  - Recovery of Function
KW  - Retrospective Studies
KW  - Risk Assessment
KW  - Risk Factors
KW  - Severity of Illness Index
KW  - Stroke Volume
KW  - Time Factors
KW  - Transcatheter Aortic Valve Replacement/ae [Adverse Effects]
KW  - Treatment Outcome
KW  - Ventricular Dysfunction, Left/dg [Diagnostic Imaging]
KW  - Ventricular Dysfunction, Left/mo [Mortality]
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006
N2  - BACKGROUND: Patients with severe AS, left ventricular dysfunction, and low transaortic gradient are at high risk for mortality during surgical aortic valve replacement (SAVR). Furthermore, patients without CR have been shown to have perioperative mortality comparable to that of patients treated medically for severe AS; CONCLUSION: In patients with low-flow, low-gradient severe AS undergoing TAVR, the presence or absence of CR does not predict all-cause mortality at 30 days or 1 year; Copyright (c) 2018 Wiley Periodicals, Inc; METHODS: We retrospectively analyzed patients who underwent TAVR with a diagnosis of low-gradient severe AS (mean transvalvular aortic gradient < 40 mmHg, LVEF < 50%, and AVA <= 1.0 cm<sup>2</sup> or AVAi <= 0.6 cm<sup>2</sup> ) and who had a pre-TAVR dobutamine stress echocardiogram (DSE). Patients were stratified by the presence or absence of CR, defined as an increase in stroke volume >= 20% during DSE; OBJECTIVES: The aim of this study was to determine the prognostic value of contractile reserve (CR) at baseline in patients with low-flow, low-gradient severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR); RESULTS: From 2008 to 2016, 61 patients with low-gradient severe AS underwent TAVR and had pre-TAVR DSE. CR was present in 31 patients (51%) and absent in 30 (49%). There was no significant difference between the two groups in baseline demographics, medical history, access site, or types of valves. All-cause mortality was similar in both groups at 30 days (13% with CR vs 10% without CR, P = 1.00) and 1 year (29% with CR vs 33% without CR, HR 1.20, 95% CI 0.49-2.96, P = 0.69)
UR  - https://dx.doi.org/10.1002/ccd.27914
ER  -