1. Late Outcomes of Transcatheter Aortic Valve Replacement in High-Risk Patients
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Martine Gilard, Hélène Eltchaninoff, Patrick Donzeau-Gouge, Karine Chevreul, Jean Fajadet, Pascal Leprince, Alain Leguerrier, Michel Lievre, Alain Prat, Emmanuel Teiger, Thierry Lefevre, Didier Tchetche, Didier Carrié, Dominique Himbert, Bernard Albat, Alain Cribier, Arnaud Sudre, Didier Blanchard, Gilles Rioufol, Frederic Collet, Remi Houel, Pierre Dos Santos, Nicolas Meneveau, Said Ghostine, Thibaut Manigold, Philippe Guyon, Dominique Grisoli, Herve Le Breton, Stephane Delpine, Romain Didier, Xavier Favereau, Geraud Souteyrand, Patrick Ohlmann, Vincent Doisy, Gilles Grollier, Antoine Gommeaux, Jean-Philippe Claudel, Francois Bourlon, Bernard Bertrand, Marc Laskar, Bernard Iung, Michel Bertrand, Jean Cassagne, Jacques Boschat, Jean Rene Lusson, Pierre Mathieu, Yves Logeais, Jean-Paul Bessou, Bernard Chevalier, Arnaud Farge, Philippe Garot, Thomas Hovasse, Marie Claude Morice, Mauro Romano, Patrick Donzeau Gouge, Olivier Vahdat, Bruno Farah, Didier Carrie, Nicolas Dumonteil, Gérard Fournial, Bertrand Marcheix, Patrick Nataf, Alec Vahanian, Florence Leclercq, Christophe Piot, Laurent Schmutz, Pierre Aubas, A. du Cailar, A. Dubar, N. Durrleman, F. Fargosz, Gilles Levy, Eric Maupas, François Rivalland, G. Robert, Christophe Tron, Francis Juthier, Thomas Modine, Eric Van Belle, Carlo Banfi, Thierry Sallerin, Olivier Bar, Christophe Barbey, Stephan Chassaing, Didier Chatel, Olivier Le Page, Arnaud Tauran, Daniele Cao, Raphael Dauphin, Guy Durand de Gevigney, Gérard Finet, Olivier Jegaden, Jean-François Obadia, Farzin Beygui, Jean-Philippe Collet, Alain Pavie, Frédéric Collet, null Pecheux, null Bayet, Alain Vaillant, Jacques Vicat, Olivier Wittenberg, Rémi Houel, Patrick Joly, Roger Rosario, Patrice Bergeron, Jacques Bille, Richard Gelisse, Jean-Paul Couetil, Jean-Luc Dubois Rande, Delphine Hayat, Emilie Fougeres, Jean-Luc Monin, Gauthier Mouillet, Florence Arsac, Emmanuel Choukroun, Marina Dijos, Jean-Philippe Guibaud, Lionel Leroux, Nicolas Elia, null Descotes Genon, Sidney Chocron, François Schiele, Christophe Caussin, Alexandre Azmoun, Saïd Ghostine, Rémi Nottin, Ashok Tirouvanziam, Dominique Crochet, Régis Gaudin, Jean-Christian Roussel, Nicolas Bonnet, Franck Digne, Patrick Mesnidrey, Thierry Royer, Victor Stratiev, Jean-Louis Bonnet, Thomas Cuisset, Hervé Le Breton, Issal Abouliatim, Marc Bedossa, Dominique Boulmier, Jean Philippe Verhoye, Stéphane Delepine, Jean-Louis Debrux, Alain Furber, Frédéric Pinaud, Eric Bezon, Jean-Noel Choplain, Oliver Bical, Grégoire Dambrin, Philippe Deleuze, Arnaud Jegou, Jean-René Lusson, Kasra Azarnouch, Nicolas Durel, Andrea Innorta, Géraud Souteyrand, Yves Lienhart, Ricardo Roriz, Patrick Staat, Jean-Noël Fabiani, Antoine Lafont, Rachid Zegdi, Didier Heudes, Michel Kindo, Jean-Philippe Mazzucotelli, Michel Zupan, Calin Ivascau, Thérèse Lognone, Massimo Massetti, Rémy Sabatier, Bruno Huret, Philippe Hochart, Damien Bouchayer, François Gabrielle, Franck Pelissier, Guillaume Tremeau, François Bourlon, Gilles Dreyfus, Armand Eker, Yakoub Habib, Nicolas Hugues, Claude Mialhe, Olivier Chavanon, Paolo Porcu, and Gérald Vanzetto
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medicine.medical_specialty ,Framingham Risk Score ,Transcatheter aortic ,business.industry ,Incidence (epidemiology) ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,medicine.disease ,3. Good health ,Surgery ,03 medical and health sciences ,Stenosis ,0302 clinical medicine ,Valve replacement ,Aortic valve stenosis ,medicine ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,Risk assessment ,business ,Prospective cohort study - Abstract
BACKGROUND Transcatheter aortic valve replacement (TAVR) has revolutionized management of high-risk patients with severe aortic stenosis. However, survival and the incidence of severe complications have been assessed in relatively small populations and/or with limited follow-up. OBJECTIVES This report details late clinical outcome and its determinants in the FRANCE-2 (FRench Aortic National CoreValve and Edwards) registry. METHODS The FRANCE-2 registry prospectively included all TAVRs performed in France. Follow-up was scheduled at 30 days, at 6 months, and annually from 1 to 5 years. Standardized VARC (Valve Academic Research Consortium) outcome definitions were used. RESULTS A total of 4,201 patients were enrolled between January 2010 and January 2012 in 34 centers. Approaches were transarterial (transfemoral 73%, transapical 18%, subclavian 6%, and transaortic or transcarotid 3%) or, in 18% of patients, transapical. Median follow-up was 3.8 years. Vital status was available for 97.2% of patients at 3 years. The 3-year all-cause mortality was 42.0% and cardiovascular mortality was 17.5%. In a multivariate model, predictors of 3-year all-cause mortality were male sex (p = 2 of 4 (p < 0.001). Severe events according to VARC criteria occurred mainly during the first month and subsequently in < 2% of patients/year. Mean gradient, valve area, and residual aortic regurgitation were stable during follow-up. CONCLUSIONS The FRANCE-2 registry represents the largest database available on late results of TAVR. Late mortality is largely related to noncardiac causes. Incidence rates of severe events are low after the first month. Valve performance remains stable over time. (J Am Coll Cardiol 2016; 68: 1637-47) (C) 2016 by the American College of Cardiology Foundation.
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- 2016