RT Journal Article
SR Electronic
T1 Predictors of early mortality after transcatheter aortic valve implantation
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e000936
DO 10.1136/openhrt-2018-000936
VO 6
IS 1
A1 Didrik Kjønås
A1 Gry Dahle
A1 Henrik Schirmer
A1 Siri Malm
A1 Jo Eidet
A1 Lars Aaberge
A1 Terje Steigen
A1 Svend Aakhus
A1 Rolf Busund
A1 Assami Rösner
YR 2019
UL http://openheart.bmj.com/content/6/1/e000936.abstract
AB Objectives To investigate whether preoperative echocardiographic evaluation of ventricular function, especially right ventricular systolic and diastolic parameters including speckle-tracking analysis, could aid in the prediction of 30-day mortality after transcatheter aortic valve implantation (TAVI) in patients with aortic stenosis.Methods This is a prospective observational cohort study including 227 patients accepted for TAVI at the University Hospital of North Norway and Oslo University Hospital from February 2010 through June 2013. All patients underwent preoperative transthoracic echocardiography with retrospective speckle-tracking analysis. Primary endpoint was all-cause 30-day mortality.Results All-cause 30-day mortality was 8.7 % (n = 19). Independent predictors of 30-day mortality were systolic pulmonary arterial pressure (SPAP) > 60 mm Hg (HR: 7.7, 95% CI: 1.90 to 31.3), heart failure (HR: 2.9, 95% CI: 1.1 to 7.78), transapical access (HR: 3.8, 95% CI: 1.3 to 11.2), peripheral artery disease (HR: 6.0, 95% CI: 2.0 to 18.0) and body mass index (HR: 0.73, 95% CI: 0.61 to 0.87). C-statistic for the model generated was 0.91 (95% CI: 0.85 to 0.98). Besides elevated SPAP, no other echocardiographic measurements were found to be an independent predictor of early mortality.Conclusion Except for elevated systolic pulmonary artery pressure, our data suggests that clinical rather than echocardiographic parameters are useful predictors of 30-day mortality after TAVI.