Urgent transcatheter aortic valve implantation in an all-comer population: a single-centre experience

A. Lux*, L.F. Veenstra, S. Kats, W. Dohmen, J.G. Maessen, A.W.J.V. Hof, B. Maesen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background When compared with older reports of untreated symptomatic aortic valve stenosis (AoS), urgent transcatheter aortic valve implantation (u-TAVI) seems to improve mortality rates. We performed a single centre, retrospective cohort analysis to characterize our u-TAVI population and to identify potential predictors of worse outcomes. Methods We performed a retrospective analysis of 631 consecutive TAVI patients between 2013 and 2018. Of these patients, 53 were categorized as u-TAVI. Data was collected from the local electronic database. Results Urgent patients had more often a severely decreased left ventricular ejection fraction (LVEF < 30%) and increased creatinine levels (115.5 [88-147] vs 94.5 [78-116] mmol/l; p = 0.001). Urgent patients were hospitalised for 18 [10-28] days before and discharged 6 [4-9] days after the implantation. The incidence of peri-procedural complications and apical implantations was comparable among the study groups. Urgent patients had higher in-hospital (11.3% vs 3.1%; p = 0.011) and 1-year mortality rates (28.2% vs 8.5%, p < 0.001). An increased risk of one-year mortality was associated with urgency (HR 3.5; p < 0.001), apical access (HR 1.9; p = 0.016) and cerebrovascular complications (HR 4.3; p = 0.002). Within the urgent group, the length of pre-hospital admission was the only significant predictor of 1-year mortality (HR 1.037/day; p = 0.003). Conclusions Compared to elective procedures, u-TAVI led to increased mortality and comparable complication rates. This detrimental effect is most likely related to the length of pre-procedural hospitalisation of urgent patients.
Original languageEnglish
Article number550
Number of pages8
JournalBMC Cardiovascular disorders
Volume21
Issue number1
DOIs
Publication statusPublished - 19 Nov 2021

Keywords

  • Transcatheter valve implantation
  • TAVI
  • Urgency
  • Hospitalisation
  • REPLACEMENT
  • STENOSIS
  • VALVULOPLASTY
  • MANAGEMENT
  • FAILURE
  • DISEASE

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