Patients and methods
Patient population
Paravalvular leakage
Endpoint
Postinterventional protocol
Statistical analysis
Results
Baseline and procedural characteristics
Overall (n = 394) | Group 1: ≤75 (n = 28) | Group 2: ≤76–80 (n = 107) | Group 3: 81–85 (n = 148) | Group 4: >85 (n = 111) | p | |
---|---|---|---|---|---|---|
A | ||||||
Age, years | 82.6 ± 4.9 | 72.8 ± 3.3 | 78.6 ± 1.4 | 83.0 ± 1.4 | 88.3 ± 2.4 | <0.001 |
Male gender | 184 (46.7) | 19 (67.9) | 54 (50.5) | 69 (46.6) | 42 (37.8) | 0.027 |
Weight, kg | 75.7 ± 15.4 | 84.2 ± 13.7 | 79.7 ± 16.0 | 75.7 ± 12.8 | 69.8 ± 16.3 | <0.001 |
Height, cm | 167.2 ± 10.1 | 172.0 ± 8.0 | 167.5 ± 8.5 | 168.2 ± 8.6 | 164.4 ± 13.0 | <0.001 |
Logistic EuroSCORE, % | 15.5 ± 10.7 | 12.7 ± 10.0 | 11.5 ± 7.5 | 14.8 ± 9.9 | 20.9 ± 12.2 | <0.001 |
Aortic valve area, cm2 | 0.7 ± 0.2 | 0.7 ± 0.3 | 0.7 ± 0.2 | 0.7 ± 0.2 | 0.6 ± 0.2 | 0.046 |
Mean transvalvular PG before TAVR, mm Hg | 47.0 ± 16.0 | 45.8 ± 17.4 | 45.5 ± 16.8 | 48.3 ± 16.8 | 46.7 ± 16.9 | 0.41 |
LVEF, % | 54.1 ± 11.1 | 48.6 ± 14.6 | 53.7 ± 10.5 | 54.8 ± 10.9 | 55.1 ± 10.5 | 0.16 |
CAD | 215 (54.6) | 15 (53.6) | 55 (51.4) | 80 (54.1) | 65 (58.6) | 0.76 |
Prior MI | 49 (12.4) | 4 (14.3) | 12 (11.2) | 15 (10.1) | 18 (16.2) | 0.47 |
Prior PCI | 127 (32.2) | 11(39.3) | 35 (32.7) | 42 (28.4) | 39 (35.1) | 0.54 |
Prior heart surgery | 32 (8.1) | 4 (14.3) | 12 (11.2) | 10 (6.8) | 6 (5.4) | 0.2 |
PVD | 40 (10.2) | 2 (7.1) | 13 (12.1) | 11 (7.4) | 14 (12.6) | 0.44 |
B | ||||||
Mean transvalvular PG after TAVR, mm Hg | 10.4 ± 4.4 | 10.7 ± 4.3 | 10.4 ± 4.5 | 10.5 ± 4.2 | 10.2 ± 4.6 | 0.88 |
Vascular complications (major) | 18 (4.7) | 2 (7.1) | 19 (17.8) | 20 (13.5) | 16 (14.4) | 0.56 |
Vascular complications (minor) | 23 (6.0) | 0 (0) | 8 (7.6) | 8 (5.6) | 7(6.5) | 0.58 |
Stroke (disabling) | 5 (1.3) | 0 (0) | 2 (1.9) | 3 (2.0) | 0 (0) | 0.49 |
Stroke (non-disabling) | 6 (1.5) | 1 (3.6) | 1 (0.9) | 2 (1.4) | 2 (1.8) | 0.64 |
Mortality and peri-interventional complications
Paravalvular leakage after TAVR
PVL | ≤85 years (n = 279) | >85 years (n = 111) | p |
---|---|---|---|
A | |||
Absent (0/4) | 180 (64.5%) | 78 (70.3%) | – |
Trace or mild (1/4) | 70 (25.1%) | 27 (24.3%) | – |
Moderate (2/4) | 29 (10.4%) | 6 (5.4%) | 0.27 |
Moderate-to-severe (3/4) | 0 (0%) | 0 (0%) | – |
Severe (4/4) | 0 (0%) | 0 (0%) | – |
B | |||
∆PDAP–LVEDP <18 mm Hg | 37 (13.7) | 10 (9.1) | 0.30 |