Outcomes After Transcatheter Aortic Valve Replacement in Patients with Severe Aortic Stenosis and Diastolic Dysfunction

Outcomes After Transcatheter Aortic Valve Replacement in Patients with Severe Aortic Stenosis and Diastolic Dysfunction

© 2021 Saudi Heart Association.

Bibliographische Detailangaben
Veröffentlicht in:Journal of the Saudi Heart Association. - 1999. - 33(2021), 1 vom: 29., Seite 26-34
1. Verfasser: AlHarbi, Hassan (VerfasserIn)
Weitere Verfasser: AlAhmari, Mohammed, Alanazi, Abdulrahman M, Al-Ghamdi, Bander, AlSuayri, Abdullah, AlHaydhal, Ahmed, Arafat, Amr A, Algarni, Khaled D, Abdelsalam, Wiam, AlRajwi, Sameera, AlMoghairi, Abdulrahman, AlAmri, Hussin, AlAhmari, Saeed, AlOtaiby, Mohammed
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2021
Zugriff auf das übergeordnete Werk:Journal of the Saudi Heart Association
Schlagworte:Journal Article Diastolic dysfunction Survival Transcatheter aortic valve replacement
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245 1 0 |a Outcomes After Transcatheter Aortic Valve Replacement in Patients with Severe Aortic Stenosis and Diastolic Dysfunction 
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520 |a OBJECTIVES: Left ventricular diastolic dysfunction (LVDD) in patients undergoing transcatheter aortic valve replacement (TAVR) is associated with poor outcomes; however, the effect of its severity is controversial. We sought to assess the impact of diastolic dysfunction on hospital outcomes and survival after TAVR and identify prognostic factors 
520 |a METHODS: We included patients who underwent TAVR for severe aortic stenosis with preexisting LVDD from 2009 to 2018 (n = 325). Patients with prior mitral valve surgery (n = 4), atrial fibrillation (n = 39), missing or poor baseline diastolic dysfunction assessment (n = 36) were excluded. The primary endpoint was all-cause mortality. 246 patients were included in the study 
520 |a RESULTS: The median age was 80 years (25th and 75th percentiles:75-86.7), 154 (62.6%) were males and the median EuroSCORE II was 4.3 (2.2-8). Patients with severe LVDD had significantly higher EuroSCORE, and lower ejection fraction (p < 0.001). There was no difference in post-TAVR new atrial fibrillation (p = 0.912), pacemaker insertion (p = 0.528), stroke (p = 0.76), or hospital mortality (p = 0.95). Patients with severe LVDD had longer hospital stay (p = 0.036). The grade of LVDD did not affect survival (log-rank = 0.145) nor major adverse cardiovascular events (log-rank = 0.97). Predictors of mortality were; low BMI (HR: 0.95 (0.91-0.99); p = 0.019), low sodium (0.93 (0.82-2.5); p = 0.021), previous PCI (HR: 1.6 (1.022-2.66); p = 0.04), E-peak (HR: 1.01 (1.002-1.019); p = 0.014) and implantation of more than one device (HR: 3.55 (1.22-10.31); p = 0.02) 
520 |a CONCLUSION: Transcatheter aortic valve replacement is feasible in patients with diastolic dysfunction, and the degree of diastolic dysfunction did not negatively affect the outcome. Long-term outcomes in those patients were affected by the preoperative clinical state and procedure-related factors 
650 4 |a Journal Article 
650 4 |a Diastolic dysfunction 
650 4 |a Survival 
650 4 |a Transcatheter aortic valve replacement 
700 1 |a AlAhmari, Mohammed  |e verfasserin  |4 aut 
700 1 |a Alanazi, Abdulrahman M  |e verfasserin  |4 aut 
700 1 |a Al-Ghamdi, Bander  |e verfasserin  |4 aut 
700 1 |a AlSuayri, Abdullah  |e verfasserin  |4 aut 
700 1 |a AlHaydhal, Ahmed  |e verfasserin  |4 aut 
700 1 |a Arafat, Amr A  |e verfasserin  |4 aut 
700 1 |a Algarni, Khaled D  |e verfasserin  |4 aut 
700 1 |a Abdelsalam, Wiam  |e verfasserin  |4 aut 
700 1 |a AlRajwi, Sameera  |e verfasserin  |4 aut 
700 1 |a AlMoghairi, Abdulrahman  |e verfasserin  |4 aut 
700 1 |a AlAmri, Hussin  |e verfasserin  |4 aut 
700 1 |a AlAhmari, Saeed  |e verfasserin  |4 aut 
700 1 |a AlOtaiby, Mohammed  |e verfasserin  |4 aut 
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