Universität zu Köln

El-Chilali, Karim, Al-Rashid, Fadi, Riebisch, Matthias, Kahlert, Heike Annelie, Mincu, Raluca-Ileana, Totzeck, Matthias, Lind, Alexander, Janosi, Rolf Alexander, Dirkmann, Daniel, Peters, Juergen, Wendt, Daniel, Thielmann, Matthias, Jakob, Heinz, Ruhparwar, Arjang, Rassaf, Tienush and Kahlert, Philipp (2020). Impact of Bioprosthetic Choice on Mortality After Transfemoral Transcatheter Aortic Valve Implantation in Patients With Reduced Versus Preserved Left-Ventricular Ejection Fraction. Am. J. Cardiol., 125 (10). S. 1550 - 1558. BRIDGEWATER: EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC. ISSN 1879-1913

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Abstract

The outcome of transfemoral transcatheter aortic valve implantation (TF-TAVI) with a selfexpanding (SEP) versus a balloon-expandable prosthesis (BEP) in patients with a reduced ejection fraction (rEF, <= 40%) has not been previously investigated. Patients with rEF have an increased risk of death after TF-TAVI compared to patients with a preserved ejection fraction (pEF), and prosthesis choice might influence the outcome of these patients. We, therefore, sought to compare all-cause mortality of patients with rEF using a SEP versus a BEP. We retrospectively analyzed data of 679 single-center TF-TAVI patients. Patients were censored at death or completion of 1-year follow-up, whichever occurred first. Patients with rEF (n = 141, 21%) had an increased 1-year mortality compared to patients with pEF (28% vs 19%, p = 0.007). SEP were implanted in 149 patients (49 with rEF, 33%), while BEP were implanted in 530 patients (92 with rEF, 17%). In patients with pEF, 1-year mortality was similar after SEP- and BEP-implantation (16% vs 19%, p = 0.516). In patients with rEF, however, 1-year mortality was higher after SEP- than after BEP-implantation (43% vs 21%, p = 0.004). These patients had a higher incidence of new permanent pace-maker implantation (26.5% vs 13%, p = 0.046) and paravalvular leak >= II degrees (21% vs 10%, p = 0.07), but both factors could not explain the excess mortality after SEP-implantation in the multivariate analysis. In patients with rEF, the use of a SEP was an independent predictor of 1-year mortality (HR 2.44, 95% CI 1.27 to 4.27, p = 0.007). In conclusion, patients with rEF had a higher 1-year mortality after TF-TAVI when a SEP instead of a BEP was used. (C) 2020 Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code El-Chilali, Karim UNSPECIFIED UNSPECIFIED UNSPECIFIED Al-Rashid, Fadi UNSPECIFIED UNSPECIFIED UNSPECIFIED Riebisch, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Kahlert, Heike Annelie UNSPECIFIED UNSPECIFIED UNSPECIFIED Mincu, Raluca-Ileana UNSPECIFIED UNSPECIFIED UNSPECIFIED Totzeck, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Lind, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Janosi, Rolf Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Dirkmann, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Peters, Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Wendt, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Thielmann, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Jakob, Heinz UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruhparwar, Arjang UNSPECIFIED UNSPECIFIED UNSPECIFIED Rassaf, Tienush UNSPECIFIED UNSPECIFIED UNSPECIFIED Kahlert, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-333727
DOI:	10.1016/j.amjcard.2020.02.022
Journal or Publication Title:	Am. J. Cardiol.
Volume:	125
Number:	10
Page Range:	S. 1550 - 1558
Date:	2020
Publisher:	EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
Place of Publication:	BRIDGEWATER
ISSN:	1879-1913
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PERMANENT PACEMAKER IMPLANTATION; REPLACEMENT; OUTCOMES; INSIGHTS Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33372