Assisted care as a baseline patient risk characteristic affecting the outcome of transcatheter aortic valve insertion. Issue 7 (8th June 2016)

• Record Type: Journal Article
• Authors: Traynor, Megan M.; Greason, Kevin L.; Nkomo, Vuyisile T.; Pochettino, Alberto; Holmes, David R.; Rihal, Charanjit S.; Reeder, Guy S.; Bresnahan, John F.; Mathew, Verghese
• Is Part Of: Catheterization and cardiovascular interventions. Volume 89:Issue 7(2017)
• Page Start: 1268
• Page End: 1272
• Publication Date: 2016-06-08
• Subjects: transcatheter aortic valve insertion -- assisted care; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.26580
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract : Background: Objective measures of frailty have not been well defined as risk factors for a poor outcome after transcatheter aortic valve insertion. We hypothesized that assisted care as a baseline patient characteristic was a simple objective measure of frailty. We reviewed our experience to assess for an association between assisted care and outcome of operation. Methods: We retrospectively reviewed the records of 597 patients operated with transcatheter aortic valve insertion from November 2008 through July 2015. The study cohort included patients with a dichotomous baseline characteristic of receiving assisted care (AC group, n = 60, 10.1%) or not receiving assisted care (NC group, n = 537, 89.9%). The endpoints of the study were operative stroke/death and 1‐year survival. Results: The age of the patients was 80.6 ± 9.0 years, male sex was present in 349 (58.5%), and STS predicted risk of mortality was 9.2 ± 6.2%. Alternate access was used in 26 (43.3%) patients in the AC care group and in 220 (41.0%) in the NC group ( P = 0.724). Operative stroke/death occurred in 4 (6.7%) patients in the AC group and in 25 (4.7%) in the NC group ( P = 0.492). Mortality at 1 year in the AC group was 14.8 ± 5.2% and in the NC group was 12.9 ± 1.7%; ( P = 0. 250). Conclusions: Assisted care as a baseline patient characteristic does not result in increased operative stroke/death or 1‐year mortality in patients following transcatheter aortic valve insertion. Assisted care should not by itself preclude operation. © 2016 Wiley Periodicals, Inc.