Outcomes of Patients With Severe Chronic Lung Disease Who Are Undergoing Transcatheter Aortic Valve Replacement

The Annals of Thoracic Surgery
Rakesh M SuriDavid R Holmes

Abstract

In this study, we sought to determine the clinical outcomes after transcatheter aortic valve replacement (TAVR) among patients with chronic lung disease (CLD) and to evaluate the safety of transaortic versus transapical alternate access approaches in patients with varying severities of CLD. Clinical records for patients undergoing TAVR from 2011 to 2014 in The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry were linked to Medicare hospital claims (n = 11,656). Clinical outcomes were evaluated across strata of CLD severity, and the risk-adjusted association between access route and post-TAVR mortality was determined among patients with severe CLD. In this cohort (median age, 84 years; 51.7% female), moderate to severe CLD was present in 27.7% (14.3%, moderate; 13.4%, severe). Compared with patients with no or mild CLD, patients with severe CLD had a higher rate of post-TAVR mortality to 1-year (32.3% versus 21.0%; adjusted hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.31 to 1.66), as did those with moderate CLD (25.5%; adjusted HR, 1.16; 95% CI, 1.03 to 1.30). The adjusted rate of mortality was similar for transapical versus transaortic approaches to 1 year (adjusted HR...Continue Reading

References

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Citations

Jul 20, 2016·Revista española de geriatría y gerontología·Baldomero Álvarez-FernándezRicardo Gómez-Huelgas
Sep 22, 2016·Current Cardiology Reports·Jayendrakumar S PatelSamir R Kapadia
Apr 15, 2018·Journal of Cardiac Surgery·Kevin L GreasonDavid R Holmes
Jun 9, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Liang TangMario Gössl
Sep 7, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Vinod H ThouraniRichard Weisel
Nov 20, 2016·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Jose F CondadoVasilis Babaliaros
Dec 2, 2020·Clinical Cardiology·Nauman KhalidWaleed Tallat Kayani
Jan 7, 2021·Journal of Cardiac Surgery·Cesar E Mendoza, Diego Celli
Mar 30, 2021·Radiology. Cardiothoracic Imaging·Cheng Ting LinStefan Loy Zimmerman

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