Abstract 2660: Population Characteristics, Treatment Assignment And Survival Of Elderly Patients With Aortic Stenosis Referred For Percutaneous Valve Replacement
Department of Cardiology and CardioThoracic Surgery, Thoraxcenter, Erasmus Medical Center Rotterdam, The Netherlands. Introduction An increasing number of elderly are being referred for percutaneous aortic valve replacement (PAVR). Although case studies are available on treatment and outcome and phase II studies are ongoing, little is known about the demographics of the total population referred in addition to treatment assignment and survival of the entire population. We sought to determine this by means of a prospective observational cohort study.
Patients and methods Since the initiation of PAVR in our institution (November 2005), 101 patients were referred for PAVR. Predefined demographic, clinical, technical, laboratory and procedural variables were prospectively entered into a dedicated database. Follow-up of vital status was obtained by contacting the civil registries. The follow-up was complete for all patients.
Results About half of the patients were female (54%). The Euroscore was highest in the PAVR (19%) and lowest in the AVR (9%). Patients who refused PAVR had a higher mortality than those who underwent PAVR (25% vs 6%). AVR= surgical valve replacement; PABV= percutaneous aortic balloon valvuloplasty; No-candidate= patients did not qualify for treatment based upon guidelines.
Conclusion Most patients referred for PAVR are female. There is a rather uniform distribution of treatment assignment, except for PABV. AVR treated patients have the lowest risk score, yet a higher mortality than the PAVR group. Patients who refused treatment and those under evaluation had the highest mortality. It is conceivable that in the latter group, earlier referral and treatment may reduce mortality.