Impact of unfavorable aortic anatomy on transcatheter aortic valve replacement outcomes.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Sammartino Sofia, Laterra Giulia, Saia Francesco, Pilgrim Thomas, Abdel-Wahab Mohamed, Garot Philippe, Gandolfo Caterina, Adamo Marianna, Latib Azeem, Santos Ignacio Amat, Mylotte Darren, De Marco Federico, De Backer Ole, Franco Luis Nombela, Akodad Mariama, Ribichini Flavio Luciano, Bedogni Francesco, Palmerini Tullio, Tomii Daijiro, Laforgia Pietro, Cannata Stefano, Branca Luca, Scotti Andrea, Fezzi Simone, Criscione Enrico, Poletti Enrico, Lunardi Mattia, Mainardi Andrea, Andreaggi Stefano, Quagliana Angelo, Montarello Nicholas, Hennessey Breda, Mon-Noboa Matias, Meier David, Sgroi Carmelo, Valvo Roberto, Reddavid Claudia Maria, Strazzieri Orazio, Motta Silvia Crescenzia, Frittitta Valentina, Dipietro Elena, Comis Alessandro, Calì Mariachiara, Rosa Luigi La, Agnello Federica, Thiele Holger, Webb John G, Sondergaard Lars, Tamburino Corrado, Costa Giuliano, Barbanti Marco
Аннотация
METHODS: Patients enrolled in the multicenter OPERA-TAVI registry were considered. Patients were compared using propensity score matching according to the presence or absence of unfavorable anatomical characteristics of the aortic root [bicuspid aortic valve (BAV), moderate-to-severe left ventricular outflow tract calcifications, horizontal aorta]. Primary endpoints were Valve Academic Research Consortium (VARC)-3 device success and early safety. The secondary endpoint was a composite of 1-year all-cause death, disabling stroke and heart failure rehospitalization.
RESULTS: Among a total of 1815 patients, 629 patients (34.7%) had at least one unfavorable characteristic. After adjustment, 624 matched pairs of patients were compared.VARC-3 device success (85.3% vs. 92.0%, P < 0.001) and early safety (72.9% vs. 79.6%, P = 0.006) were lower in patients with unfavorable characteristics. The secondary composite endpoint was higher in patients with unfavorable anatomical characteristics (Kaplan-Meier estimates 15.3 vs. 12.0%; Plogrank = 0.019). Among patients with unfavorable anatomical characteristics, BAV alone was associated with early safety [odds ratio 2.15, 95% confidence interval 1.04-4.70, P = 0.05].
CONCLUSIONS: Patients undergoing transfemoral TAVR had lower rates of device success and early safety in the presence of unfavorable anatomical characteristics, along with worse 1-year clinical outcomes. However, BAV was associated with higher early safety in this context.