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Transcatheter aortic valve replacement outcomes in mixed aortic valve disease compared to predominant aortic stenosis.
- Source :
-
International journal of cardiology [Int J Cardiol] 2020 Jan 15; Vol. 299, pp. 209-214. Date of Electronic Publication: 2019 Aug 01. - Publication Year :
- 2020
-
Abstract
- Background: MAVD, defined as severe aortic stenosis with moderate or severe aortic regurgitation, is frequently encountered in clinical practice. However, the data regarding TAVR outcomes in MAVD are sparse. We compared Transcatheter Aortic Valve Replacement (TAVR) outcomes between Mixed Aortic Valve Disease (MAVD) and Predominant Aortic Stenosis (PAS) patients.<br />Methods: Patients who underwent TAVR at Mayo Clinic from February 7, 2012 to December 16, 2016 were enrolled. The primary end point was all-cause mortality. Secondary end points were central or paravalvular regurgitation, device success, and Valve Academic Research Consortium (VARC)-2 defined post TAVR complications (access site complications, bleedings, myocardial infarction, stroke, and cardiac arrest).<br />Results: A total of 622 patients were enrolled. Mean age was 81 ± 8.9 years, and 263 (42.3%) were female. Median follow-up duration was 1.5 years. One hundred and sixteen patients (18.6%) had MAVD. Central or paravalvular leak was higher in MAVD patients post-TAVR (15.5% vs 6.7%, P = 0.004). Device success and VARC-2 in-hospital complications were similar between the two groups. The cumulative probability of survival at 3 years was 71.3% in MAVD patients vs. 62.6% in PAS patients (Log-Rank P = 0.024). In a multi-variant logistic regression analysis, MAVD was an independent negative predictor of all-cause mortality (HR = 0.53, 95% CI 0.3-0.89, P = 0.015).<br />Conclusions: A significant number of patients referred for TAVR have MAVD disease. Despite higher rates of paravalvular regurgitation, all-cause mortality at mid-term was lower in patients with MAVD compared with those with PAS. Our results show the safety and efficacy of TAVR in MAVD patients.<br /> (Copyright © 2019 Elsevier B.V. All rights reserved.)
- Subjects :
- Aged
Aged, 80 and over
Aortic Valve Insufficiency diagnostic imaging
Aortic Valve Stenosis diagnostic imaging
Cohort Studies
Female
Follow-Up Studies
Humans
Male
Retrospective Studies
Survival Rate trends
Transcatheter Aortic Valve Replacement trends
Treatment Outcome
Aortic Valve Insufficiency mortality
Aortic Valve Insufficiency surgery
Aortic Valve Stenosis mortality
Aortic Valve Stenosis surgery
Transcatheter Aortic Valve Replacement mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1874-1754
- Volume :
- 299
- Database :
- MEDLINE
- Journal :
- International journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 31402161
- Full Text :
- https://doi.org/10.1016/j.ijcard.2019.07.099