Urgent transcatheter aortic valve implantation in an all-comer population: a single-centre experience

Abstract Background When compared with older reports of untreated symptomatic aortic valve stenosis (AoS), urgent transcatheter aortic valve implantation (u-TAVI) seems to improve mortality rates. We performed a single centre, retrospective cohort analysis to characterize our u-TAVI population and t...

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Autores principales:	Arpad Lux, Leo F. Veenstra, Suzanne Kats, Wim Dohmen, Jos G. Maessen, Arnoud W. J. van ’t Hof, Bart Maesen
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Transcatheter valve implantation TAVI Urgency Hospitalisation Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/df68341bcb1b48d6a191dcf969aa2c92
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spelling	oai:doaj.org-article:df68341bcb1b48d6a191dcf969aa2c922021-11-21T12:04:06ZUrgent transcatheter aortic valve implantation in an all-comer population: a single-centre experience10.1186/s12872-021-02347-11471-2261https://doaj.org/article/df68341bcb1b48d6a191dcf969aa2c922021-11-01T00:00:00Zhttps://doi.org/10.1186/s12872-021-02347-1https://doaj.org/toc/1471-2261Abstract Background When compared with older reports of untreated symptomatic aortic valve stenosis (AoS), urgent transcatheter aortic valve implantation (u-TAVI) seems to improve mortality rates. We performed a single centre, retrospective cohort analysis to characterize our u-TAVI population and to identify potential predictors of worse outcomes. Methods We performed a retrospective analysis of 631 consecutive TAVI patients between 2013 and 2018. Of these patients, 53 were categorized as u-TAVI. Data was collected from the local electronic database. Results Urgent patients had more often a severely decreased left ventricular ejection fraction (LVEF < 30%) and increased creatinine levels (115.5 [88–147] vs 94.5 [78–116] mmol/l; p = 0.001). Urgent patients were hospitalised for 18 [10–28] days before and discharged 6 [4–9] days after the implantation. The incidence of peri-procedural complications and apical implantations was comparable among the study groups. Urgent patients had higher in-hospital (11.3% vs 3.1%; p = 0.011) and 1-year mortality rates (28.2% vs 8.5%, p < 0.001). An increased risk of one-year mortality was associated with urgency (HR 3.5; p < 0.001), apical access (HR 1.9; p = 0.016) and cerebrovascular complications (HR 4.3; p = 0.002). Within the urgent group, the length of pre-hospital admission was the only significant predictor of 1-year mortality (HR 1.037/day; p = 0.003). Conclusions Compared to elective procedures, u-TAVI led to increased mortality and comparable complication rates. This detrimental effect is most likely related to the length of pre-procedural hospitalisation of urgent patients.Arpad LuxLeo F. VeenstraSuzanne KatsWim DohmenJos G. MaessenArnoud W. J. van ’t HofBart MaesenBMCarticleTranscatheter valve implantationTAVIUrgencyHospitalisationDiseases of the circulatory (Cardiovascular) systemRC666-701ENBMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Transcatheter valve implantation TAVI Urgency Hospitalisation Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Transcatheter valve implantation TAVI Urgency Hospitalisation Diseases of the circulatory (Cardiovascular) system RC666-701 Arpad Lux Leo F. Veenstra Suzanne Kats Wim Dohmen Jos G. Maessen Arnoud W. J. van ’t Hof Bart Maesen Urgent transcatheter aortic valve implantation in an all-comer population: a single-centre experience
description	Abstract Background When compared with older reports of untreated symptomatic aortic valve stenosis (AoS), urgent transcatheter aortic valve implantation (u-TAVI) seems to improve mortality rates. We performed a single centre, retrospective cohort analysis to characterize our u-TAVI population and to identify potential predictors of worse outcomes. Methods We performed a retrospective analysis of 631 consecutive TAVI patients between 2013 and 2018. Of these patients, 53 were categorized as u-TAVI. Data was collected from the local electronic database. Results Urgent patients had more often a severely decreased left ventricular ejection fraction (LVEF < 30%) and increased creatinine levels (115.5 [88–147] vs 94.5 [78–116] mmol/l; p = 0.001). Urgent patients were hospitalised for 18 [10–28] days before and discharged 6 [4–9] days after the implantation. The incidence of peri-procedural complications and apical implantations was comparable among the study groups. Urgent patients had higher in-hospital (11.3% vs 3.1%; p = 0.011) and 1-year mortality rates (28.2% vs 8.5%, p < 0.001). An increased risk of one-year mortality was associated with urgency (HR 3.5; p < 0.001), apical access (HR 1.9; p = 0.016) and cerebrovascular complications (HR 4.3; p = 0.002). Within the urgent group, the length of pre-hospital admission was the only significant predictor of 1-year mortality (HR 1.037/day; p = 0.003). Conclusions Compared to elective procedures, u-TAVI led to increased mortality and comparable complication rates. This detrimental effect is most likely related to the length of pre-procedural hospitalisation of urgent patients.
format	article
author	Arpad Lux Leo F. Veenstra Suzanne Kats Wim Dohmen Jos G. Maessen Arnoud W. J. van ’t Hof Bart Maesen
author_facet	Arpad Lux Leo F. Veenstra Suzanne Kats Wim Dohmen Jos G. Maessen Arnoud W. J. van ’t Hof Bart Maesen
author_sort	Arpad Lux
title	Urgent transcatheter aortic valve implantation in an all-comer population: a single-centre experience
title_short	Urgent transcatheter aortic valve implantation in an all-comer population: a single-centre experience
title_full	Urgent transcatheter aortic valve implantation in an all-comer population: a single-centre experience
title_fullStr	Urgent transcatheter aortic valve implantation in an all-comer population: a single-centre experience
title_full_unstemmed	Urgent transcatheter aortic valve implantation in an all-comer population: a single-centre experience
title_sort	urgent transcatheter aortic valve implantation in an all-comer population: a single-centre experience
publisher	BMC
publishDate	2021
url	https://doaj.org/article/df68341bcb1b48d6a191dcf969aa2c92
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Urgent transcatheter aortic valve implantation in an all-comer population: a single-centre experience

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