Abstract 15150: Patients With Aortic Stenosis and Pulmonary Hypertension Experience a Decrease in Pulmonary Artery Pressure Following Transcatheter Aortic Valve Replacement
BACKGROUND: Pulmonary hypertension (PHTN) is a major risk factor for patients undergoing cardiac surgery as it associated with high peri- and post-operative mortality. While PHTN is frequent among patients with severe aortic stenosis (AS), there is no data to assess the prognostic ramifications of PHTN among patients who undergo transcatheter aortic valve replacement (TAVR).
OBJECTIVE: To assess the prevalence and clinical impact of PHTN on patients with severe AS who undergo TAVR.
METHODS: Clinical data of patients with AS who underwent TAVR was retrospectively analyzed. Patients were divided into two groups based on systolic pulmonary artery pressure: 0-50 mmHg (No/Mild group) versus >50 mmHg (moderate/severe group). Two-way ANOVA was performed to assess trends in pulmonary systolic pressure.
RESULTS: A total of 321 patients were included in the present analysis. No/mild PHTN was present in 182 (57%) and moderate/severe PHTN in 139 (43%). The average age was 84±7 years and 48% were male. Average STS score was 10.8±4.7. There were no significant differences between groups in baseline characteristics or in baseline echo, apart from moderate/severe tricuspid regurgitation, which was more frequent among moderate/severe PHTN patients (23% vs. 5.9%, p <0.001) and average baseline pulmonary pressure (61±12 vs. 36±9, p <0.001). Transfemoral access was more frequent among moderate/severe PHTN patients (75% vs. 64%, p=0.04); however, other procedural and post-procedural complications were similar between groups. Systolic pulmonary artery pressure significantly decreased among patients with moderate/severe PHTN. (Figure) Mortality up to 1-year follow up was comparable (24.5% vs. 19.2%, p=0.26).
CONCLUSIONS: TAVR for patients with AS and significant PHTN is a viable treatment option as it is not associated with early or late hazards. Furthermore, these patients benefit from significant decreases in the pulmonary artery pressure.
- © 2013 by American Heart Association, Inc.