Author + information
- Maxime Doutriaux,
- Nicolas Bettinger,
- Najime Bouhzam,
- Christophe Tron,
- Bastien Glinel Mortreuil,
- Fabrice Bauer,
- Eric Durand and
- Helene Eltchaninoff
Background: Transcatheter Aortic Valve Replacement (TAVR) is indicated in patients with symptomatic severe aortic stenosis in whom surgery is considered high-risk or contraindicated. Very few studies have investigated the frequency of rehospitalization for congestive heart failure (CHF) after TAVR and its prognostic impact and its predictive factors have not been studied.
Objectives: We sought to assess the incidence, predictive and prognostic factors of rehospitalization for CHF in a population of patients with severe aortic stenosis treated by TAVR.
Methods: All patients undergoing TAVR from January 2010 to December 2014 at Rouen University Hospital have been included. Follow-up has been achieved for at least 1 year and included clinical, biological and echocardiographic data.
Results: This report included 546 patients, 291 (53,3%) were female, mean age was 83.9 ± 7.3 and mean logistic EuroSCORE was 15.6 ± 10.9%. Among these patients, 534 (97,8%) have been implanted with a balloon-expandable valve (Sapien XT® and Sapien 3®) and 482 (87.8%) via a trans-femoral approach. At one year, hospitalization related to CHF and mortality rates were respectively 24.2% and 13.7%. Mortality rate was significantly higher in the group of patients re-hospitalized due to CHF (24.2% vs 10.4%, p<0.0001). By multivariate analysis, a low aortic mean gradient [HR=1.14; CI 95% (1.01-1.27); p=0.03], post-procedural blood transfusion [HR=2.27; CI 95% (1.13-5.56); p=0.009], severe post-procedural pulmonary hypertension [HR=1.04; CI 95% (1.00-1.07); p<0.0001] and left atrial dilatation [HR=1.47; CI 95% (1.08-2.01); p=0.02] were independently associated with CHF re-hospitalization at 1 year.
Conclusions: Re-hospitalization for CHF after TAVR remains a frequent issue and is strongly associated with 1-year mortality.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: TAVR 4
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1283-131
- 2017 American College of Cardiology Foundation