Transcatheter aortic valve implantation: predictors of procedural success-the Siegburg-Bern experience

被引:86
作者
Buellesfeld, Lutz [1 ]
Wenaweser, Peter [2 ]
Gerckens, Ulrich [1 ]
Mueller, Ralf [1 ]
Sauren, Barthel [3 ]
Latsios, Georg [1 ]
Zickmann, Bernfried [3 ]
Hellige, Gerrit [2 ]
Windecker, Stephan [2 ]
Grube, Eberhard [1 ]
机构
[1] HELIOS Heart Ctr Siegburg, Dept Cardiol Angiol, D-53721 Siegburg, Germany
[2] Univ Hosp Bern, Dept Cardiol, CH-3010 Bern, Switzerland
[3] HELIOS Heart Ctr Siegburg, Dept Anaesthesiol, D-53721 Siegburg, Germany
关键词
Percutaneous aortic valve implantation; Aortic stenosis; Predictors; HIGH-RISK PATIENTS; PROSTHESIS; STENOSIS; REPLACEMENT; DISEASE;
D O I
10.1093/eurheartj/ehp570
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims The purpose of the present analysis was to identify predictors of procedural success of percutaneous transcatheter aortic valve implantation (TAVI). Methods and results 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 Core Valve 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 cm(2). 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% Cl 0.13-0.82, P = 0.017), prior coronary intervention (OR 5.3, 95% Cl 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% Cl 1.00-1.08, P = 0.032) in the multivariate analysis. Conclusion 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.
引用
收藏
页码:984 / 991
页数:8
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