Coronary Access and Percutaneous Coronary Intervention up to 3 Years after Transcatheter Aortic Valve Implantation with a Balloon-Expandable Valve
Articolo
Data di Pubblicazione:
2020
Citazione:
Coronary Access and Percutaneous Coronary Intervention up to 3 Years after Transcatheter Aortic Valve Implantation with a Balloon-Expandable Valve / G. Tarantini, L. Nai Fovino, P. Le Prince, O. Darremont, M. Urena, A. Bartorelli, F. Vincent, T. Hovorka, Y. Alcala Navarro, N. Dumonteil, P. Ohlmann, O. Wendler. - In: CIRCULATION. CARDIOVASCULAR INTERVENTIONS. - ISSN 1941-7632. - 13:7(2020 Jul), pp. e008972.1-e008972.7. [10.1161/CIRCINTERVENTIONS.120.008972]
Abstract:
Background: Coronary artery disease and aortic stenosis often coexist. Transcatheter aortic valve implantation (TAVI) has emerged as a valid therapeutic option for younger, lower-risk patients who may eventually require coronary artery disease treatment. Thus, post-TAVI coronary access (CA) and percutaneous coronary intervention are expected to increase. The purpose of this study was to retrospectively evaluate patients who were enrolled in the SOURCE 3 (SAPIEN 3 Aortic Bioprosthesis European Outcome) European registry for treatment with the balloon-expandable SAPIEN 3 transcatheter heart valve and underwent CA with or without percutaneous coronary intervention after TAVI. Methods: Baseline characteristics and clinical outcomes of patients with or without CA up to 3 years after TAVI were compared. A Kaplan-Meier estimate with a univariate model determined the impact of CA on cardiac mortality. Results: Of 1936 TAVI patients (mean age 81.6 years, 52% male), 68 (3.5%) had CA within 3 years (mean 441±332 days) after TAVI. At baseline, the logistic EuroSCORE was similar (20.2% versus 18.3%, P=0.2, CA and non-CA groups, respectively). Higher rates of coronary artery disease (76.5% versus 50.6%, P<0.001), myocardial infarction (20.6% versus 11.5%, P=0.03) and previous coronary artery bypass graft (22.1% versus 11.0%, P=0.01) were present in the CA group. In 100% of patients, CA was successfully achieved. The clinical success of percutaneous coronary intervention was 97.9%. Cardiovascular mortality was numerically higher in patients with CA than in those without CA. Conclusions: In the large SOURCE 3 European registry, CA was needed at 3-year follow-up after TAVI with a balloon-expandable valve in 3.5% of patients and was successful in all patients. The clinical success of percutaneous coronary intervention was 97.9%.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
coronary access; coronary artery disease; heart valves; mortality; myocardial infarction; percutaneous coronary intervention; transcatheter aortic valve
Elenco autori:
G. Tarantini, L. Nai Fovino, P. Le Prince, O. Darremont, M. Urena, A. Bartorelli, F. Vincent, T. Hovorka, Y. Alcala Navarro, N. Dumonteil, P. Ohlmann, O. Wendler
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