Author + information
- Yan Fan,
- David Zhao,
- Robert Applegate,
- Sanjay Gandhi,
- Brandon Stacey,
- Sujethra Vasu and
- Min Pu
Background: Prior studies have showed that the prognosis of patients (pts) with low gradient severe aortic stenosis (LG SAS) and preserved left ventricular function (LVEF) is influenced by comorbidities and surgical risks. Whether aortic valve intervention (AVI) could improve long term outcome in LG SAS patients with different surgical risks is not clear.
Methods: The current study enrolled 317 pts with LG SAS and preserved LVEF. The pts were divided into 2 groups according to surgical risk stratification by EuroSCORE II: a high-risk group (EuroSCORE II≥3.5%, n=137) and a low-risk group (EuroSCORE II<3.5%, n=180). Forty-four pts in the high-risk group and 43 pts in the low-risk group had AVI (either surgical or transcatheter aortic valve replacement). Pts were followed up for mean 2±1.3 years. All-cause mortality was used as an endpoint.
Results: Two-year cumulative survival was significantly lower in the high-risk group than in low-risk group (62% vs. 81%, p<0.001) with medical management. In the high-risk group, survival significantly improved in pts receiving AVI than those without (62 % vs. 73%, p=0.024, Figure). The 2-year survival rate was similar in the low-risk group in pts with and without AVI (86% vs. 81%, p=0.47).
Conclusions: High surgical-risk pts with LG SAS and preserved LVEF carries poor prognosis with medical therapy and AVI improves survival. There is no survival benefit of AVI in low risk pts, suggesting that risk stratification is necessary for identifying the pts who benefit most from AVI.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Valvular Disease Populations at Risk
Abstract Category: 37. Valvular Heart Disease: Therapy
Presentation Number: 1104-032
- 2017 American College of Cardiology Foundation