Abstract 4292: Predictors of 30-day Mortality After Transcatheter Aortic Valve Implantation: Results From the Expanded Evaluation Registry With the 3rd Generation CoreValve ReValving System
Background: Determinants of 30-day mortality after transcatheter aortic valve implantation (TAVI) have not yet been reported. Risk factor knowledge can affect the patient selection process, influence post-procedural management of patients, and improve patient informed consent.
Objective: To identify predictors of 30-day mortality after TAVI in patients implanted with the 18F CoreValve ReValving System (CRS) as part of the Expanded Evaluation Registry (20 countries, 105 sites).
Methods: Between April 2007 to February 2009 clinical specialists prospectively collected data on 1521 patients implanted with a CRS. Pre-procedural (35 variables), intra-procedural (4 variables), and post-procedural (3 variables) factors that were univariately found to be associated with 30-day mortality were tested by a forward logistic regression analysis after forcing age, gender, and logistic EuroSCORE into the model.
Results: The mean age of the patients was 82±6 years and mean logistic EuroSCORE of 23±14%. Procedural success was achieved in 97.7% of patients. Overall mortality at 30 days was 10.3%. In the multivariable analysis, NYHA class (p=0.01), COPD (p<0.001), post-procedural aortic regurgitation grade (p=0.0015), and post-procedural rhythm [atrial fibrillation (p=0.026) and paced rhythm (p=0.029)] remained as independent predictors of 30-day mortality.
Conclusion: Both pre- and post-procedural factors can influence mortality at 30-days after TAVI. These factors can be considered during the patient selection process, in making treatment decisions and risk stratification of patients pre- and post-procedure.