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Patients’ characteristics and mortality in urgent/emergent/salvage transcatheter aortic valve replacement: insight from the OCEAN-TAVI registry
- Source :
- Open Heart, Open Heart, Vol 7, Iss 2 (2020)
- Publication Year :
- 2020
- Publisher :
- BMJ, 2020.
-
Abstract
- ObjectivesPatients’ backgrounds and clinical outcomes in urgent/emergent/salvage transcatheter aortic valve replacement (Em-TAVR) remain unclear. We investigated patient characteristics and the mortality in Em-TAVR and the predictors for the need for Em-TAVR.MethodsWe consecutively enrolled 1613 patients undergoing TAVR for severe aortic stenosis between October 2013 and July 2016 from the Optimised transCathEter vAlvular interventioN (OCEAN)-transcatheter aortic valve implantation (TAVI) registry. The urgency was based on the European System for Cardiac Operative Risk Evaluation II. Urgent, emergent or salvage were included with the Em-TAVR group and elective with the El-TAVR group.ResultsEm-TAVR was observed in 87 (5.4%) patients. A higher Clinical Frailty Scale (CFS), peripheral artery disease (PAD), hypoalbuminaemia, reduced left ventricular ejection fraction (LVEF) and preoperative at least moderate mitral regurgitation (MR) predicted the need for the Em-TAVR by the multivariate logistic regression analysis. The Em-TAVR group had the higher Society of Thoracic Surgeons Score (13.7 (IQR 8.2–21.0) vs 6.5 (IQR 4.6–9.2); pConclusionsEm-TAVR was performed in 5.4% of patients. Higher CFS, PAD, hypoalbuminaemia, reduced LVEF and preprocedural MR predicted the need for Em-TAVR. Em-TAVR was not a predictor for mortality in the multivariate analysis, suggesting that it is a reasonable treatment option.
- Subjects :
- Male
Aortic valve
lcsh:Diseases of the circulatory (Cardiovascular) system
medicine.medical_specialty
Multivariate analysis
medicine.medical_treatment
aortic valve stenosis
Logistic regression
Severity of Illness Index
Transcatheter Aortic Valve Replacement
Japan
Valve replacement
Risk Factors
Internal medicine
medicine
Humans
Prospective Studies
Registries
Aged, 80 and over
Mitral regurgitation
Ejection fraction
business.industry
medicine.disease
heart valve prosthesis implantation
Survival Rate
Stenosis
medicine.anatomical_structure
lcsh:RC666-701
Aortic Valve
Valvular Heart Disease
Aortic valve stenosis
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 20533624
- Volume :
- 7
- Database :
- OpenAIRE
- Journal :
- Open Heart
- Accession number :
- edsair.doi.dedup.....8bdaec237de890f3b912da99a5f5b14c