Long-Term Outcomes After Transcatheter Aortic Valve Implantation in High-Risk Patients With Severe Aortic Stenosis: The U.K. TAVI (United Kingdom Transcatheter Aortic Valve Implantation) Registry

The objective was to define the characteristics of a real-world patient population treated with transcatheter aortic valve implantation (TAVI), regardless of technology or access route, and to evaluate their clinical outcome over the mid to long term. Although a substantial body of data exists in re...

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Veröffentlicht in:Journal of the American College of Cardiology 2011-11, Vol.58 (20), p.2130-2138
Hauptverfasser: MOAT, Neil E, LUDMAN, Peter, WENDLER, Olaf, HILDICK-SMITH, David, DAVIES, Simon W, TRIVEDI, Uday, BLACKMAN, Daniel J, LEVY, Richard D, BRECKER, Stephen J. D, BAUMBACH, Andreas, DANIEL, Tim, GRAY, Huon, DE BELDER, Mark A, MULLEN, Michael J, BRIDGEWATER, Ben, CUNNINGHAM, Andrew D, YOUNG, Christopher P, THOMAS, Martyn, KOVAC, Jan, SPYT, Tom, MACCARTHY, Philip A
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container_issue 20
container_start_page 2130
container_title Journal of the American College of Cardiology
container_volume 58
creator MOAT, Neil E
LUDMAN, Peter
WENDLER, Olaf
HILDICK-SMITH, David
DAVIES, Simon W
TRIVEDI, Uday
BLACKMAN, Daniel J
LEVY, Richard D
BRECKER, Stephen J. D
BAUMBACH, Andreas
DANIEL, Tim
GRAY, Huon
DE BELDER, Mark A
MULLEN, Michael J
BRIDGEWATER, Ben
CUNNINGHAM, Andrew D
YOUNG, Christopher P
THOMAS, Martyn
KOVAC, Jan
SPYT, Tom
MACCARTHY, Philip A
description The objective was to define the characteristics of a real-world patient population treated with transcatheter aortic valve implantation (TAVI), regardless of technology or access route, and to evaluate their clinical outcome over the mid to long term. Although a substantial body of data exists in relation to early clinical outcomes after TAVI, there are few data on outcomes beyond 1 year in any notable number of patients. The U.K. TAVI (United Kingdom Transcatheter Aortic Valve Implantation) Registry was established to report outcomes of all TAVI procedures performed within the United Kingdom. Data were collected prospectively on 870 patients undergoing 877 TAVI procedures up until December 31, 2009. Mortality tracking was achieved in 100% of patients with mortality status reported as of December 2010. Survival at 30 days was 92.9%, and it was 78.6% and 73.7% at 1 year and 2 years, respectively. There was a marked attrition in survival between 30 days and 1 year. In a univariate model, survival was significantly adversely affected by renal dysfunction, the presence of coronary artery disease, and a nontransfemoral approach; whereas left ventricular function (ejection fraction
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D ; BAUMBACH, Andreas ; DANIEL, Tim ; GRAY, Huon ; DE BELDER, Mark A ; MULLEN, Michael J ; BRIDGEWATER, Ben ; CUNNINGHAM, Andrew D ; YOUNG, Christopher P ; THOMAS, Martyn ; KOVAC, Jan ; SPYT, Tom ; MACCARTHY, Philip A</creator><creatorcontrib>MOAT, Neil E ; LUDMAN, Peter ; WENDLER, Olaf ; HILDICK-SMITH, David ; DAVIES, Simon W ; TRIVEDI, Uday ; BLACKMAN, Daniel J ; LEVY, Richard D ; BRECKER, Stephen J. D ; BAUMBACH, Andreas ; DANIEL, Tim ; GRAY, Huon ; DE BELDER, Mark A ; MULLEN, Michael J ; BRIDGEWATER, Ben ; CUNNINGHAM, Andrew D ; YOUNG, Christopher P ; THOMAS, Martyn ; KOVAC, Jan ; SPYT, Tom ; MACCARTHY, Philip A</creatorcontrib><description>The objective was to define the characteristics of a real-world patient population treated with transcatheter aortic valve implantation (TAVI), regardless of technology or access route, and to evaluate their clinical outcome over the mid to long term. Although a substantial body of data exists in relation to early clinical outcomes after TAVI, there are few data on outcomes beyond 1 year in any notable number of patients. The U.K. TAVI (United Kingdom Transcatheter Aortic Valve Implantation) Registry was established to report outcomes of all TAVI procedures performed within the United Kingdom. Data were collected prospectively on 870 patients undergoing 877 TAVI procedures up until December 31, 2009. Mortality tracking was achieved in 100% of patients with mortality status reported as of December 2010. Survival at 30 days was 92.9%, and it was 78.6% and 73.7% at 1 year and 2 years, respectively. There was a marked attrition in survival between 30 days and 1 year. In a univariate model, survival was significantly adversely affected by renal dysfunction, the presence of coronary artery disease, and a nontransfemoral approach; whereas left ventricular function (ejection fraction &lt;30%), the presence of moderate/severe aortic regurgitation, and chronic obstructive pulmonary disease remained the only independent predictors of mortality in the multivariate model. Midterm to long-term survival after TAVI was encouraging in this high-risk patient population, although a substantial proportion of patients died within the first year.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2011.08.050</identifier><identifier>PMID: 22019110</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier</publisher><subject>Aged ; Aged, 80 and over ; Aortic Valve Stenosis - surgery ; Biological and medical sciences ; Cardiology ; Cardiology. 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D</creatorcontrib><creatorcontrib>BAUMBACH, Andreas</creatorcontrib><creatorcontrib>DANIEL, Tim</creatorcontrib><creatorcontrib>GRAY, Huon</creatorcontrib><creatorcontrib>DE BELDER, Mark A</creatorcontrib><creatorcontrib>MULLEN, Michael J</creatorcontrib><creatorcontrib>BRIDGEWATER, Ben</creatorcontrib><creatorcontrib>CUNNINGHAM, Andrew D</creatorcontrib><creatorcontrib>YOUNG, Christopher P</creatorcontrib><creatorcontrib>THOMAS, Martyn</creatorcontrib><creatorcontrib>KOVAC, Jan</creatorcontrib><creatorcontrib>SPYT, Tom</creatorcontrib><creatorcontrib>MACCARTHY, Philip A</creatorcontrib><title>Long-Term Outcomes After Transcatheter Aortic Valve Implantation in High-Risk Patients With Severe Aortic Stenosis: The U.K. TAVI (United Kingdom Transcatheter Aortic Valve Implantation) Registry</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>The objective was to define the characteristics of a real-world patient population treated with transcatheter aortic valve implantation (TAVI), regardless of technology or access route, and to evaluate their clinical outcome over the mid to long term. Although a substantial body of data exists in relation to early clinical outcomes after TAVI, there are few data on outcomes beyond 1 year in any notable number of patients. The U.K. TAVI (United Kingdom Transcatheter Aortic Valve Implantation) Registry was established to report outcomes of all TAVI procedures performed within the United Kingdom. Data were collected prospectively on 870 patients undergoing 877 TAVI procedures up until December 31, 2009. Mortality tracking was achieved in 100% of patients with mortality status reported as of December 2010. Survival at 30 days was 92.9%, and it was 78.6% and 73.7% at 1 year and 2 years, respectively. There was a marked attrition in survival between 30 days and 1 year. In a univariate model, survival was significantly adversely affected by renal dysfunction, the presence of coronary artery disease, and a nontransfemoral approach; whereas left ventricular function (ejection fraction &lt;30%), the presence of moderate/severe aortic regurgitation, and chronic obstructive pulmonary disease remained the only independent predictors of mortality in the multivariate model. Midterm to long-term survival after TAVI was encouraging in this high-risk patient population, although a substantial proportion of patients died within the first year.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Biological and medical sciences</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular disease</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Confidence intervals</subject><subject>Diabetes</subject><subject>Endocardial and cardiac valvular diseases</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Heart Valve Prosthesis Implantation - mortality</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Mortality</subject><subject>Postoperative Complications - epidemiology</subject><subject>Prostheses</subject><subject>Registries</subject><subject>Stroke</subject><subject>Surgery</subject><subject>Transplants &amp; implants</subject><subject>Treatment Outcome</subject><subject>United Kingdom - epidemiology</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkcFu1DAQhi0EokvhBTggSwhRDgkex47t3lZVoauuVNRmyzFyYmfXy8ZZbKdSn68vRoCtkDggTqMZffPPzD8IvQaSA4Hy4zbf6rbNKQHIicwJJ0_QDDiXWcGVeIpmRBQ8A6LEEXoR45YQUkpQz9ERnXoUAJmhh-Xg11llQ4-vxtQOvY143iUbcBW0j61OG_szmw8huRbf6t2dxYt-v9M-6eQGj53HF269ya5d_Ia_TDXrU8RfXdrgG3tng33svUnWD9HFU1xtLF7llzmu5rcLfLLyLlmDL51fm6H_38Ef8LVdu5jC_Uv0rNO7aF8d4jFafTqvzi6y5dXnxdl8me0LAilrldCGGtIY0KUihgvLGPBSGSqpZg10LeFCd4Y3VhpBGWEUmAZDdScaUMUxev9bdx-G76ONqe5dbO1uWskOY6wVoUVBORQTefJPEiSAVJL9En37F7odxuCnO2rgwKQUJWET9eZAjU1vTb0Prtfhvn585AS8OwB68m7XTR62Lv7hmKCypKT4AZEJrpU</recordid><startdate>20111108</startdate><enddate>20111108</enddate><creator>MOAT, Neil E</creator><creator>LUDMAN, Peter</creator><creator>WENDLER, Olaf</creator><creator>HILDICK-SMITH, David</creator><creator>DAVIES, Simon W</creator><creator>TRIVEDI, Uday</creator><creator>BLACKMAN, Daniel J</creator><creator>LEVY, Richard D</creator><creator>BRECKER, Stephen J. 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D ; BAUMBACH, Andreas ; DANIEL, Tim ; GRAY, Huon ; DE BELDER, Mark A ; MULLEN, Michael J ; BRIDGEWATER, Ben ; CUNNINGHAM, Andrew D ; YOUNG, Christopher P ; THOMAS, Martyn ; KOVAC, Jan ; SPYT, Tom ; MACCARTHY, Philip A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p301t-c97ad2d0bd1a690d57e441569d282a4b1fc057afd5be8d72404214a1d2af7b193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Biological and medical sciences</topic><topic>Cardiology</topic><topic>Cardiology. 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In a univariate model, survival was significantly adversely affected by renal dysfunction, the presence of coronary artery disease, and a nontransfemoral approach; whereas left ventricular function (ejection fraction &lt;30%), the presence of moderate/severe aortic regurgitation, and chronic obstructive pulmonary disease remained the only independent predictors of mortality in the multivariate model. Midterm to long-term survival after TAVI was encouraging in this high-risk patient population, although a substantial proportion of patients died within the first year.</abstract><cop>New York, NY</cop><pub>Elsevier</pub><pmid>22019110</pmid><doi>10.1016/j.jacc.2011.08.050</doi><tpages>9</tpages></addata></record>
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subjects Aged
Aged, 80 and over
Aortic Valve Stenosis - surgery
Biological and medical sciences
Cardiology
Cardiology. Vascular system
Cardiovascular disease
Chronic obstructive pulmonary disease
Confidence intervals
Diabetes
Endocardial and cardiac valvular diseases
Female
Follow-Up Studies
Heart
Heart attacks
Heart Valve Prosthesis Implantation - mortality
Hospitals
Humans
Male
Medical prognosis
Medical sciences
Mortality
Postoperative Complications - epidemiology
Prostheses
Registries
Stroke
Surgery
Transplants & implants
Treatment Outcome
United Kingdom - epidemiology
title Long-Term Outcomes After Transcatheter Aortic Valve Implantation in High-Risk Patients With Severe Aortic Stenosis: The U.K. TAVI (United Kingdom Transcatheter Aortic Valve Implantation) Registry
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