Valvular heart diseaseLong-Term Outcome of Patients With Moderate and Severe Prosthetic Aortic Valve Regurgitation After Transcatheter Aortic Valve Implantation
Section snippets
Methods
Patients with symptomatic, severe aortic stenosis (aortic valve area ≤1.0 cm2) and high risk for surgical aortic valve replacement were screened for transfemoral or transaxillary TAVI. Risk of surgical aortic valve replacement was estimated with the logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE). Indications, contraindications, and anatomic requirements for TAVI were described previously.16
After the procedure patients were subdivided into groups depending on the
Results
In total 202 consecutive patients with native aortic stenosis (n = 197) or degenerated aortic bioprosthesis (n = 5) who underwent transfemoral (n = 197) or transaxillary (n = 5) TAVI with the CoreValve prosthesis were enrolled.
During the procedure 3 patients died (rupture of eccentric calcified aortic base, n = 1; fatal vascular access-related complications, n = 2). These patients died before the prosthesis was implanted and evaluation of AR was not possible. Hence, these patients were excluded
Discussion
Our study highlights the prognostic impact of moderate and severe ARs after TAVI with a self-expandable transcatheter valve. The main finding is that moderate/severe AR is a main contributor to long-term all-cause and cardiovascular mortality. In addition, we illustrate the mechanisms of AR and meaning of AR on functional status and hemodynamic function.
Although transcatheter valves have favorable hemodynamic performance, prosthetic AR is a common complication.22 Recently, we described several
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