Outcomes Following Urgent/Emergent Transcatheter Aortic Valve Replacement
In: JACC: Cardiovascular Interventions, Jg. 11 (2018-06-01), S. 1175-1185
Online
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Zugriff:
Objectives The authors sought to examine outcomes and identify independent predictors of mortality among patients undergoing urgent/emergent transcatheter aortic valve replacement (TAVR). Background Data on urgent/emergent TAVR as a rescue therapy for decompensated severe aortic stenosis (AS) are limited. Methods The Society of Thoracic Surgeons and the American College of Cardiology Transcatheter Valve Therapy (STS/ACC TVT) Registry linked with Centers for Medicare & Medicaid Services claims was used to identify patients who underwent urgent/emergent versus elective TAVR between November 2011 and June 2016. Outcomes assessed were device success rate, in-hospital major adverse events, and 30-day and 1-year mortality. Independent predictors of mortality after urgent/emergent TAVR were examined. Results Of 40,042 patients who underwent TAVR, 3,952 (9.9%) were urgent/emergent (median STS PROM score 11.8 [interquartile range: 7.6 to 17.9]). Device success rate was statistically lower, but not clinically different after urgent/emergent versus elective TAVR (92.6% vs. 93.7%; p = 0.007). Rates of major and/or life-threatening bleeding, major vascular complications, myocardial infarction, stroke, new permanent pacemaker placement, conversion to SAVR, and paravalvular regurgitation were similar between the 2 groups. Compared with elective TAVR, patients undergoing urgent/emergent TAVR had higher rates of acute kidney injury and/or new dialysis (8.2% vs. 4.2%; p Conclusions Urgent/emergent TAVR is feasible with acceptable outcomes and may be a reasonable option in a selected group of patients with severe AS.
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Outcomes Following Urgent/Emergent Transcatheter Aortic Valve Replacement
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Autor/in / Beteiligte Person: | Inglessis, Ignacio ; Thourani, Vinod H. ; Elmariah, Sammy ; Goldsweig, Andrew M. ; Khera, Sahil ; Aronow, Herbert D. ; Gordon, Paul C. ; J. Dawn Abbott ; Palacios, Igor F. ; Dai, Dadi ; Vemulapalli, Sreekanth ; Heo, Stephan ; Sharaf, Barry L. ; Kolte, Dhaval |
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Zeitschrift: | JACC: Cardiovascular Interventions, Jg. 11 (2018-06-01), S. 1175-1185 |
Veröffentlichung: | Elsevier BV, 2018 |
Medientyp: | unknown |
ISSN: | 1936-8798 (print) |
DOI: | 10.1016/j.jcin.2018.03.002 |
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