Outcomes of patients at estimated low surgical risk undergoing transcatheter aortic valve implantation with balloon-expandable prostheses

• Published in: Cardiovascular revascularization medicine 2018-04, Vol.19 (3), p.251-256
• Main Authors: Unzué, Leire, García, Eulogio, Teijeiro, Rodrigo, Antón, Belén Díaz, del Río, Miguel Rodríguez, Solís, Jorge, Alonso, Belen Rubio, Medina, Juan, Rodrigo, Francisco José Rodríguez, Parra, Francisco Javier
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aortic Valve - diagnostic imaging; Aortic Valve - physiopathology; Aortic Valve - surgery; Aortic Valve Stenosis - diagnostic imaging; Aortic Valve Stenosis - mortality; Aortic Valve Stenosis - physiopathology; Aortic Valve Stenosis - surgery; Balloon Valvuloplasty - adverse effects; Balloon Valvuloplasty - mortality; Edwards Sapien valve; Female; Heart Valve Prosthesis; Hemodynamics; Humans; low surgical risk; Male; Prosthesis Design; Recovery of Function; Retrospective Studies; Risk Assessment; Risk Factors; Severity of Illness Index; STS score; TAVI; Time Factors; Transcatheter Aortic Valve Replacement - adverse effects; Transcatheter Aortic Valve Replacement - instrumentation; Transcatheter Aortic Valve Replacement - mortality; Treatment Outcome
• ISSN: 1553-8389; 1878-0938
• DOI: 10.1016/j.carrev.2017.08.012

Transcatheter aortic-valve implantation (TAVI) is an accepted treatment for patients with severe aortic stenosis and high surgical risk. However, there is lack in data about TAVI in low-risk patients that are already being treated with this therapy in some clinical contexts. A retrospective analysis of patients treated with transfemoral TAVI using Edwards Sapien prosthesis in one center was performed, classifying the patients into three groups according to the surgical risk (high/intermediate/low risk for STS score>8/4-8/8. Patients of low risk presented shorter hospital stay (2,91±1,6, vs 4,8±3,9 days), with lower rates of mortality at mid- and long follow-up (death from any cause 15,2% vs 0%, p 0,04). TAVI in low-risk patients is safe and associated with better outcome at mid and long-term follow-up compared to high-risk patients. What is known?•TAVI is a consolidate treatment in patients with severe symptomatic aortic stenosis and high-surgical risk (STS score>8).•The last studies have demonstrated that TAVI may be an effective and sure therapeutic alternative for patients with intermediate-surgical risk (STS score 4-8).•There is scare information about TAVI extension to patients with low-surgical risk (STS