Author + information
- Fadi Al–Rashid,
- Thomas Konorza,
- Björn Plicht,
- Polykarpos–Christos Patsalis,
- Heike Hildebrandt,
- Daniel Wendt,
- Matthias Thielmann,
- Heinz Jakob,
- Raimund Erbel and
- Philipp Kahlert
TAVI is currently transforming the treatment of non–operable and high–risk patients (pts) with severe aortic stenosis. However, surgical risk is known to be increased for pts with reduced left–ventricular ejection fraction (EF) and only few data exist about its impact in the setting of TAVI. We therefore sought to analyze the outcome of our single–center transfemoral TAVI patient cohort focussing on baseline EF.
Since 2006 358 pts underwent TF–TAVI (ES n=247; MCV n=111). We analyzed procedural data and outcome. For analysis, pts were divided into 4 groups (1 EF>55%; 2 45–54%; 3 30–44%; 4 <30%) according to their baseline EF using the “ESC Recommendations for Chamber quantification”.
TAVI was successful in 99%. Except for EuroScore there were no significant differences between groups(1 n=135; 2 n=108; 3 n=74; 4 n=41). We found a significantly higher 30–day mortality in group 4 (5 vs. 8 vs. 11 vs. 26%; p<0.001) and cumulative 1–year survival suggested the worst outcome in patients with severely reduced EF (91 vs. 90 vs. 84 vs. 64%; p<0.001). Interestingly, complication rates were not different between groups (21 vs. 16 vs. 19 vs. 23; p=0.946).
Severely reduced EF is associated with higher mortality after TAVI at 30 days and 1 year compared to normal or moderately reduced EF. However, 11% of our pts had an EF<30% and 74% were successfully treated. Therefore, strategies (eg routine stress echo) need to be evaluated in order to determine which of these high–risk pts may benefit from TAVI.
Moderated Poster Contributions
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.–4:30 p.m.
Session Title: TAVR I: Predictors of TAVR Outcomes Including LVEF, Contractile Reserve, BNP, Pulmonary HTN, CA 125, and Fever
Abstract Category: 32. Valvular Heart Disease: Therapy
Presentation Number: 1156M–86
- 2013 American College of Cardiology Foundation