Witberg, Guy, Landes, Uri, Codner, Pablo, Barbanti, Marco ORCID: 0000-0002-4903-5437, Valvo, Roberto, De Backer, Ole, Ooms, Joris F., McInerney, Angela, Masiero, Giulia, Werner, Paul, Armario, Xavier ORCID: 0000-0002-4662-0251, Fiorina, Claudia, Arzamendi, Dabit, Santos-Martinez, Sandra ORCID: 0000-0003-4244-6919, Baz, Jose A., Steblovnik, Klemen ORCID: 0000-0003-2099-6389, Mauri, Victor, Adam, Matti, Merdler, Ilan, Hein, Manuel, Ruile, Philipp, Russo, Marco, Musumeci, Francesco, Sedaghat, Alexander, Sugiura, Atsushi, Grasso, Carmelo, Branca, Luca, Estevez-Loureiro, Rodrigo ORCID: 0000-0001-5841-5514, Amat-Santos, Ignacio J., Mylotte, Darren ORCID: 0000-0001-7824-2577, Andreas, Martin ORCID: 0000-0003-4950-5432, Bunc, Matjaz, Tarantini, Giuseppe, Nombela-Franco, Luis, Sondergaard, Lars, Van Mieghem, Nicolas M., Finkelstein, Ariel and Kornowski, Ran (2022). Clinics outcomes of transcatheter aortic valve implantation in patients younger than 70 years rejected or surgery: the AMTRAC registry. EuroIntervention, 17 (16). S. 1289 - 1298. TOULOUSE CEDEX 6: EUROPA EDITION. ISSN 1969-6213

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Abstract

Background: The mean age of transcatheter aortic valve implantation (TAVI) patients is steadily decreasing. Aims: The aim of the study was to describe the characteristics, the indications for and the outcomes of TAVI in patients <70 years old. Methods: All patients patients undergoing TAVI (n=8,626) from the 18 participating centres between January 2007 dune 2020 were stratified by age (</>70). For patients <70, the indications for TAVI were extracted from Heart Team discussions and the baseline characteristics and mortality were compared between the two groups. Results: Overall, 640 (7.4%) patients were <70 (9.1% during 2018-2020, p<0.001); the mean age was 65.0 +/- 2.3 years. The younger patients were more often male, with bicuspid valves or needing valve-in-valve procedures. They had a higher prevalence of lung disease and diabetes. In 80.7% of cases, the Heart Team estimated an increased surgical risk and TAVI was selected, reflected by an STS score >4% in 20.4%. Five-year mortality was similar (29.4 vs 29.8%, HR 0.95, p=0.432) in the <70 and >70 groups. In the <70 group, mortality was higher for those referred for TAVI due to an increased surgical risk compared to those referred for other reasons (31.6 vs 24.5%, HR 1.23, p=0.021). Mortality was similar regardless of the STS stratum in patients judged by the Heart Team to be at increased surgical risk (32.6 vs 30.4%, HR 0.98, p=0.715). Conclusions: Use of TAVI in patients <70 is becoming more frequent. The main reason for choosing TAVI is due to an increased surgical risk not adequately represented by the STS score. The outcomes for these patients are similar to those for older TAVI patients. Dedicated trials of TAVI/SAVR in younger patients are needed to guide decisions concerning expansion of TAVI indications.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Witberg, GuyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Landes, UriUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Codner, PabloUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barbanti, MarcoUNSPECIFIEDorcid.org/0000-0002-4903-5437UNSPECIFIED
Valvo, RobertoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
De Backer, OleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ooms, Joris F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
McInerney, AngelaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Masiero, GiuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Werner, PaulUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Armario, XavierUNSPECIFIEDorcid.org/0000-0002-4662-0251UNSPECIFIED
Fiorina, ClaudiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arzamendi, DabitUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Santos-Martinez, SandraUNSPECIFIEDorcid.org/0000-0003-4244-6919UNSPECIFIED
Baz, Jose A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Steblovnik, KlemenUNSPECIFIEDorcid.org/0000-0003-2099-6389UNSPECIFIED
Mauri, VictorUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Adam, MattiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Merdler, IlanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hein, ManuelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruile, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Russo, MarcoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Musumeci, FrancescoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sedaghat, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sugiura, AtsushiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grasso, CarmeloUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Branca, LucaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Estevez-Loureiro, RodrigoUNSPECIFIEDorcid.org/0000-0001-5841-5514UNSPECIFIED
Amat-Santos, Ignacio J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mylotte, DarrenUNSPECIFIEDorcid.org/0000-0001-7824-2577UNSPECIFIED
Andreas, MartinUNSPECIFIEDorcid.org/0000-0003-4950-5432UNSPECIFIED
Bunc, MatjazUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tarantini, GiuseppeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nombela-Franco, LuisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sondergaard, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Van Mieghem, Nicolas M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Finkelstein, ArielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kornowski, RanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-696269
DOI: 10.4244/EIJ-D-21-00613
Journal or Publication Title: EuroIntervention
Volume: 17
Number: 16
Page Range: S. 1289 - 1298
Date: 2022
Publisher: EUROPA EDITION
Place of Publication: TOULOUSE CEDEX 6
ISSN: 1969-6213
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
VALVULAR HEART-DISEASE; EUROPEAN ASSOCIATION; CARDIOLOGY ESC; SOCIETY; REPLACEMENT; MANAGEMENTMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69626

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