Transcatheter aortic valve implantation: predictors of procedural success—the Siegburg–Bern experience
Open Access
- 27 December 2009
- journal article
- research article
- Published by Oxford University Press (OUP) in European Heart Journal
- Vol. 31 (8), 984-991
- https://doi.org/10.1093/eurheartj/ehp570
Abstract
The purpose of the present analysis was to identify predictors of procedural success of percutaneous transcatheter aortic valve implantation (TAVI). We prospectively assessed in-hospital outcome of patients undergoing TAVI at two institutions. We analysed clinical, morphological, and procedural parameters using univariate and multivariate regression models. Between 2005 and 2008, a total of 168 consecutive patients with symptomatic aortic valve stenosis underwent TAVI using the self-expanding CoreValve Revalving prosthesis. Patients (93%) were highly symptomatic with a New York Heart Association grade III/IV and a mean aortic valve area of 0.66 ± 0.21 cm2. Acute and in-hospital procedural success rates were 90.5 and 83.9%, respectively, with an in-hospital mortality, myocardial infarction, and stroke rate of 11.9, 1.8, and 3.6%, respectively. Predictors of in-hospital procedural success were type of access (OR 0.33, 95% CI 0.13–0.82, P = 0.017), prior coronary intervention (OR 5.3, 95% CI 1.20–23.41, P = 0.028) and pre-procedural Karnofsky index using univariate regression. Pre-procedural Karnofsky index emerged as the only independent predictor (OR 1.04, 95% CI 1.00–1.08, P = 0.032) in the multivariate analysis. Pre-procedural functional performance status predicts the in-hospital outcome after TAVI. Patients with a good functional status are likely to benefit more from TAVI than previously reported high-risk patients.Keywords
This publication has 10 references indexed in Scilit:
- Progress and Current Status of Percutaneous Aortic Valve Replacement: Results of Three Device Generations of the CoreValve Revalving SystemCirculation: Cardiovascular Interventions, 2008
- Percutaneous Transarterial Aortic Valve Replacement in Selected High-Risk Patients With Aortic StenosisCirculation, 2007
- Percutaneous Aortic Valve Replacement for Severe Aortic Stenosis in High-Risk Patients Using the Second- and Current Third-Generation Self-Expanding CoreValve ProsthesisJournal of the American College of Cardiology, 2007
- Percutaneous Implantation of the CoreValve Self-Expanding Valve Prosthesis in High-Risk Patients With Aortic Valve DiseaseCirculation, 2006
- Percutaneous Aortic Valve Implantation Retrograde From the Femoral ArteryCirculation, 2006
- First report on a human percutaneous transluminal implantation of a self-expanding valve prosthesis for interventional treatment of aortic valve stenosisCatheterization and Cardiovascular Interventions, 2005
- Percutaneous stent‐mounted valve for treatment of aortic or pulmonary valve diseaseCatheterization and Cardiovascular Interventions, 2004
- Early experience with percutaneous transcatheter implantation of heart valve prosthesis for the treatment of end-stage inoperable patients with calcific aortic stenosisJournal of the American College of Cardiology, 2004
- Percutaneous Transcatheter Implantation of an Aortic Valve Prosthesis for Calcific Aortic StenosisCirculation, 2002
- Karnofsky performance status revisited: reliability, validity, and guidelines.Journal of Clinical Oncology, 1984