Abstract | OBJECTIVES: METHODS: TAVIs were performed through either transfemoral or transapical access using SAPIEN (XT), CoreValve or AcurateTA valves. PCI was decided by the interdisciplinary heart team and performed synchronously or as a staged procedure upfront. Standardized valve academic research consortium (VARC)-2 endpoints were used. In case of a staged approach, TAVI was defined as the index procedure. Thirty-day outcomes and Kaplan-Meier 2-year survival were analysed. RESULTS: Of 411 TAVIs, 65 (16%) received PCI. Mean age was 82 years (P = 0.92) and mean logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) was 21.7% (TAVI + PCI) and 20.3% (TAVI; P = 0.47). PCI was performed as staged procedure upfront (74%) or synchronously (26%). In 95% of PCIs, a single coronary artery was treated, and 71% received bare metal stents. Incidence of myocardial infarction (6 vs 1%; P = 0.01) and 30-day mortality (15 vs 5%; P = 0.01) were higher in the TAVI + PCI group, compared with the TAVI group. Synchronous (18%) vs staged (15%) approach for PCI had comparable early mortality (P = 1.0). Kaplan-Meier 2-year survival was poorer in the TAVI + PCI group (P = 0.03) with an odds ratio of 1.66 (P = 0.04). CONCLUSIONS: Concomitant PCI is--when based on current heart team practice--associated with increased early and late mortality in selected elderly patients undergoing TAVI.
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Authors | Daniel P Griese, Wilko Reents, Attila Tóth, Sebastian Kerber, Anno Diegeler, Jörg Babin-Ebell |
Journal | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
(Eur J Cardiothorac Surg)
Vol. 46
Issue 1
Pg. e1-7
(Jul 2014)
ISSN: 1873-734X [Electronic] Germany |
PMID | 24819362
(Publication Type: Journal Article)
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Copyright | © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. |
Topics |
- Aged, 80 and over
- Aortic Valve
(surgery)
- Aortic Valve Stenosis
(mortality, surgery)
- Bioprosthesis
(adverse effects)
- Coronary Artery Disease
(mortality, surgery)
- Female
- Heart Valve Prosthesis
(adverse effects)
- Heart Valve Prosthesis Implantation
(methods, mortality)
- Humans
- Kaplan-Meier Estimate
- Male
- Myocardial Infarction
(epidemiology)
- Percutaneous Coronary Intervention
(mortality)
- Prosthesis Failure
- Stents
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