Does the disparity in baseline characteristics of patients undergoing transcatheter aortic valve replacement with 23 mm vs. 26 mm valves impact clinical outcome?. Issue 1 (10th August 2015)

• Record Type: Journal Article
• Authors: Escárcega, Ricardo O.; Magalhaes, Marco A.; Baker, Nevin C.; Lipinski, Michael J.; Minha, Sa'ar; Torguson, Rebecca; Chen, Fang; Satler, Lowell F.; Pichard, Augusto D.; Waksman, Ron
• Is Part Of: Catheterization and cardiovascular interventions. Volume 87:Issue 1(2016)
• Page Start: 176
• Page End: 182
• Publication Date: 2015-08-10
• Subjects: valve size -- TAVR -- aortic stenosis; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.25967
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract : Objectives: We sought to identify if baseline characteristic differences in patients who receive a 23 mm vs. 26 mm valve impact clinical outcomes. Background: Transcatheter aortic valve replacement (TAVR) is currently an approved therapy for patients with severe aortic stenosis who are considered inoperable or are at high risk. Methods: We retrospectively examined baseline characteristics and outcomes of patients receiving a 23 mm ( n = 132) vs. 26 mm valve ( n = 81) via the transfemoral approach. Results: Gender ( P < 0.01), previous coronary artery bypass surgery ( P < 0.01), history of atrial fibrillation ( P = 0.04), and mean Society of Thoracic Surgeons (STS) score ( P < 0.01) were significantly different between groups. There were no significant differences in the rates of minor/major vascular complications (2.2 vs. 3.7%, P = 0.68 and 13.0 vs. 12.3%, P = 0.89, respectively). Bleeding complications were also comparable (major bleed 2.3 vs. 1%, P >0.99, minor bleed 19.0 vs. 22.0%, P = 0.67 and life threatening bleed 7.0 vs. 5.0%, P = 0.77). In‐hospital death (6.0 vs. 5.0%, P >0.99), 30‐day all‐cause death (7.6 vs. 6.2%, P = 0.69), and all‐cause death at 1 year (17.4 vs. 25.9%, P = 0.13) were also similar between groups. Gender, valve size, previous coronary bypass surgery and atrial fibrillation were not independently associated with mortality; however, on multivariate analysis STS score was (HR 1.11; 95% CI 1.02–1.19; P = 0.01). Conclusion: Patients undergoing TAVR with 23 and 26 mm valves have similar clinical outcomes despite significant differences in baseline characteristics. © 2015 Wiley Periodicals, Inc.