Abstract 14478: Impact of Left Ventricular Systolic Function on Clinical Outcomes following Transcatheter Aortic Valve Implantation for Severe Aortic Stenosis
Introduction: Left ventricular (LV) systolic dysfunction is a well-known negative prognostic marker in patients with severe aortic stenosis (AS). We examined the effect of baseline LV ejection fraction (EF) assessed by echocardiography, on the immediate and long-term clinical outcomes of patients who underwent transcatheter aortic valve implantation (TAVI).
Methods: A total of 147 patients (age 80±7 yrs, logistic EuroSCORE 22±11) who underwent TAVI from two centers were included. Mean follow-up was 9.1±5.1 months. Procedural complications, peri- and post-operative major adverse cardiac, cerebrovascular events (MACCEs) and mortality were recorded. Survival of these patients was compared to an age-, gender-, aortic valve area and EF-matched population who underwent surgical aortic valve replacement (SAVR) for AS.
Results: At baseline, 34% of patients had EF<50%, while 66% had normal EF (≥50%). Procedural success was similar in both groups (94% vs. 97%, p=0.41). Early (≤30 days) mortality rate (10% vs. 5.2%, p=0.31) was not different between the 2 groups, despite higher rate of MACCEs (20% vs. 7.2%, p=0.03) in patients with impaired baseline EF. Although the percentage of patients free of MACCEs was higher in patients with EF<50% at long-term (Figure 1A), general survival rates at 6 and 12 months were comparable in patients with normal or impaired EF (Figure 1B). Furthermore, cumulative survival of patients with normal or impaired EF was comparable to matched groups of patients who underwent SAVR (Figure 2).
Conclusions: TAVI resulted in similar early and long-term survival in high risk patients with AS, regardless of baseline LV systolic function.
- © 2010 by American Heart Association, Inc.