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Transcatheter aortic valve implantation: predictors of procedural success—the Siegburg-Bern experience

Buellesfeld, Lutz ; Wenaweser, Peter ; Gerckens, Ulrich ; Mueller, Ralf ; Sauren, Barthel ; Latsios, Georg ; Zickmann, Bernfried ; Hellige, Gerrit ; Windecker, Stephan ; Grube, Eberhard

In: European Heart Journal, 2010, vol. 31, no. 8, p. 984-991

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    Titre
    • Transcatheter aortic valve implantation: predictors of procedural success—the Siegburg-Bern experience
    Auteur
    • Buellesfeld, Lutz. Department of Cardiology/Angiology, HELIOS Heart Center Siegburg, Ringstrasse 49, 53721 Siegburg, Germany
    • Wenaweser, Peter. Department of Cardiology, Bern University Hospital, Bern, Switzerland
    • Gerckens, Ulrich. Department of Cardiology/Angiology, HELIOS Heart Center Siegburg, Ringstrasse 49, 53721 Siegburg, Germany
    • Mueller, Ralf. Department of Cardiology/Angiology, HELIOS Heart Center Siegburg, Ringstrasse 49, 53721 Siegburg, Germany
    • Sauren, Barthel. Department of Anaesthesiology, HELIOS Heart Center Siegburg, Siegburg, Germany
    • Latsios, Georg. Department of Cardiology/Angiology, HELIOS Heart Center Siegburg, Ringstrasse 49, 53721 Siegburg, Germany
    • Zickmann, Bernfried. Department of Anaesthesiology, HELIOS Heart Center Siegburg, Siegburg, Germany
    • Hellige, Gerrit. Department of Cardiology, Bern University Hospital, Bern, Switzerland
    • Windecker, Stephan. Department of Cardiology, Bern University Hospital, Bern, Switzerland
    • Grube, Eberhard. Department of Cardiology/Angiology, HELIOS Heart Center Siegburg, Ringstrasse 49, 53721 Siegburg, Germany
    Type de document
    • Postprint
    Langue
    • Inglese
    Publié dans
    • European Heart Journal, 2010, vol. 31, no. 8, p. 984-991. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:292738
    Summary
    Aims The purpose of the present analysis was to identify predictors of procedural success of percutaneous transcatheter aortic valve implantation (TAVI). Methods and results We prospectively assessed in-hospital outcome of patients undergoing TAVI at two institutions. We analysed clinical, morphological, and procedural parameters using univariate and multivariate regression models. Between 2005 and 2008, a total of 168 consecutive patients with symptomatic aortic valve stenosis underwent TAVI using the self-expanding CoreValve Revalving prosthesis. Patients (93%) were highly symptomatic with a New York Heart Association grade III/IV and a mean aortic valve area of 0.66 ± 0.21 cm2. Acute and in-hospital procedural success rates were 90.5 and 83.9%, respectively, with an in-hospital mortality, myocardial infarction, and stroke rate of 11.9, 1.8, and 3.6%, respectively. Predictors of in-hospital procedural success were type of access (OR 0.33, 95% CI 0.13-0.82, P = 0.017), prior coronary intervention (OR 5.3, 95% CI 1.20-23.41, P = 0.028) and pre-procedural Karnofsky index using univariate regression. Pre-procedural Karnofsky index emerged as the only independent predictor (OR 1.04, 95% CI 1.00-1.08, P = 0.032) in the multivariate analysis. Conclusion Pre-procedural functional performance status predicts the in-hospital outcome after TAVI. Patients with a good functional status are likely to benefit more from TAVI than previously reported high-risk patients