Identifying Patients without a Survival Benefit following Transfemoral and Transapical Transcatheter Aortic Valve Replacement

Transcatheter aortic valve replacement (TAVR) offers a novel treatment option for patients with severe symptomatic aortic valve stenosis, particularly for patients who are unsuitable candidates for surgical intervention. However, high therapeutical costs, socio-economic considerations, and numerous...

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Autores principales:	Daniela Geisler, Piotr Nikodem Rudziński, Waseem Hasan, Martin Andreas, Ena Hasimbegovic, Christopher Adlbrecht, Bernhard Winkler, Gabriel Weiss, Andreas Strouhal, Georg Delle-Karth, Martin Grabenwöger, Markus Mach
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	futility TAVI TAVR SAVR Medicine R
Acceso en línea:	https://doaj.org/article/55321a7b85814838b8f38e06ef310546
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spelling	oai:doaj.org-article:55321a7b85814838b8f38e06ef3105462021-11-11T17:33:19ZIdentifying Patients without a Survival Benefit following Transfemoral and Transapical Transcatheter Aortic Valve Replacement10.3390/jcm102149112077-0383https://doaj.org/article/55321a7b85814838b8f38e06ef3105462021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4911https://doaj.org/toc/2077-0383Transcatheter aortic valve replacement (TAVR) offers a novel treatment option for patients with severe symptomatic aortic valve stenosis, particularly for patients who are unsuitable candidates for surgical intervention. However, high therapeutical costs, socio-economic considerations, and numerous comorbidities make it necessary to target and allocate available resources efficiently. In the present study, we aimed to identify risk factors associated with futile treatment following transfemoral (TF) and transapical (TA) TAVR. Five hundred and thirty-two consecutive patients (82 ± 9 years, female 63%) who underwent TAVR between June 2009 and December 2016 at the Vienna Heart Center Hietzing were retrospectively analyzed to identify predictors of futility, defined as all-cause mortality at one year following the procedure for the overall patient cohort, as well as the TF and TA cohort. Out of 532 patients, 91 (17%) did not survive the first year after TAVR. A multivariate logistic model identified cerebrovascular disease, home oxygen dependency, wheelchair dependency, periinterventional myocardial infarction, and postinterventional renal replacement therapy as the factors independently associated with an increased one-year mortality. Our findings underscore the significance of a precise preinterventional evaluation, as well as illustrating the subtle differences in baseline characteristics in the TF and TA cohort and their impact on one-year mortality.Daniela GeislerPiotr Nikodem RudzińskiWaseem HasanMartin AndreasEna HasimbegovicChristopher AdlbrechtBernhard WinklerGabriel WeissAndreas StrouhalGeorg Delle-KarthMartin GrabenwögerMarkus MachMDPI AGarticlefutilityTAVITAVRSAVRMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4911, p 4911 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	futility TAVI TAVR SAVR Medicine R
spellingShingle	futility TAVI TAVR SAVR Medicine R Daniela Geisler Piotr Nikodem Rudziński Waseem Hasan Martin Andreas Ena Hasimbegovic Christopher Adlbrecht Bernhard Winkler Gabriel Weiss Andreas Strouhal Georg Delle-Karth Martin Grabenwöger Markus Mach Identifying Patients without a Survival Benefit following Transfemoral and Transapical Transcatheter Aortic Valve Replacement
description	Transcatheter aortic valve replacement (TAVR) offers a novel treatment option for patients with severe symptomatic aortic valve stenosis, particularly for patients who are unsuitable candidates for surgical intervention. However, high therapeutical costs, socio-economic considerations, and numerous comorbidities make it necessary to target and allocate available resources efficiently. In the present study, we aimed to identify risk factors associated with futile treatment following transfemoral (TF) and transapical (TA) TAVR. Five hundred and thirty-two consecutive patients (82 ± 9 years, female 63%) who underwent TAVR between June 2009 and December 2016 at the Vienna Heart Center Hietzing were retrospectively analyzed to identify predictors of futility, defined as all-cause mortality at one year following the procedure for the overall patient cohort, as well as the TF and TA cohort. Out of 532 patients, 91 (17%) did not survive the first year after TAVR. A multivariate logistic model identified cerebrovascular disease, home oxygen dependency, wheelchair dependency, periinterventional myocardial infarction, and postinterventional renal replacement therapy as the factors independently associated with an increased one-year mortality. Our findings underscore the significance of a precise preinterventional evaluation, as well as illustrating the subtle differences in baseline characteristics in the TF and TA cohort and their impact on one-year mortality.
format	article
author	Daniela Geisler Piotr Nikodem Rudziński Waseem Hasan Martin Andreas Ena Hasimbegovic Christopher Adlbrecht Bernhard Winkler Gabriel Weiss Andreas Strouhal Georg Delle-Karth Martin Grabenwöger Markus Mach
author_facet	Daniela Geisler Piotr Nikodem Rudziński Waseem Hasan Martin Andreas Ena Hasimbegovic Christopher Adlbrecht Bernhard Winkler Gabriel Weiss Andreas Strouhal Georg Delle-Karth Martin Grabenwöger Markus Mach
author_sort	Daniela Geisler
title	Identifying Patients without a Survival Benefit following Transfemoral and Transapical Transcatheter Aortic Valve Replacement
title_short	Identifying Patients without a Survival Benefit following Transfemoral and Transapical Transcatheter Aortic Valve Replacement
title_full	Identifying Patients without a Survival Benefit following Transfemoral and Transapical Transcatheter Aortic Valve Replacement
title_fullStr	Identifying Patients without a Survival Benefit following Transfemoral and Transapical Transcatheter Aortic Valve Replacement
title_full_unstemmed	Identifying Patients without a Survival Benefit following Transfemoral and Transapical Transcatheter Aortic Valve Replacement
title_sort	identifying patients without a survival benefit following transfemoral and transapical transcatheter aortic valve replacement
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/55321a7b85814838b8f38e06ef310546
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Identifying Patients without a Survival Benefit following Transfemoral and Transapical Transcatheter Aortic Valve Replacement

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