Abstract 13910: The Impact of Peripheral Arterial Disease on Early Outcome After Transcatheter Aortic Valve Implantation. Results From the German TAVI Registry.
Objective: To determine the impact of peripheral arterial disease (PAD) on clinical outcome after transcatheter aortic valve implantation (TAVI).
Background: A significant proportion of patients undergoing TAVI suffers from concomitant PAD which plays a crucial role in the patient selection process and may be associated with worse outcome.
Methods: In the prospective, multi-center German TAVI registry, TAVI was performed in 1383 patients with a mean age of 81.7±6.2 years and a logistic Eu-roSCORE of 20.5±13.6%.
Results: PAD patients (21.5%) had a higher logistic EuroSCORE (28.5±16.1% vs. 18.3±11.9%; P<0.0001), suffered more often from concomitant comorbidities. After TAVI, the rate of dialysis-dependent renal failure (11.1% vs. 5.5%; P<0.001), vascular complications (27.6% vs. 20.3%; P<0.01), and in-hospital mortality (13.1% vs. 7.0%; P<0.001) was increased in PAD compared to non-PAD patients. For surgical TAVI patients with trans-apical, trans-subclavian, or trans-aortic access, in-hospital mortality rate was 17.6% for PAD vs. 11.2% for non-PAD patients compared to 11.3 vs. 6.6% for the corresponding trans-femoral patients (P<0.001). In multivariate analysis, PAD independently increased the risk of 30-day mortality [Hazard ratio (HR): 1.4, 95%-confidence interval (CI): 1.1-1.9; P=0.02] after TAVI.
Conclusions: In this real-world TAVI registry, patients with apparent PAD developed significantly more often serious adverse events and higher mortality rates. Therefore, assessment of PAD plays a crucial role in the pre-interventional selection process.
- © 2011 by American Heart Association, Inc.