Transcatheter aortic valve implantation: predictors of procedural success--the Siegburg-Bern experience.
OBJECTIVE
The purpose of the present analysis was to identify predictors of procedural success of percutaneous transcatheter aortic valve implantation (TAVI).


RESULTS
We prospectively assessed in-hospital outcome of patients undergoing TAVI at two institutions. We analysed clinical, morphological, and procedural parameters using univariate and multivariate regression models. Between 2005 and 2008, a total of 168 consecutive patients with symptomatic aortic valve stenosis underwent TAVI using the self-expanding CoreValve Revalving prosthesis. Patients (93%) were highly symptomatic with a New York Heart Association grade III/IV and a mean aortic valve area of 0.66 +/- 0.21 cm(2). Acute and in-hospital procedural success rates were 90.5 and 83.9%, respectively, with an in-hospital mortality, myocardial infarction, and stroke rate of 11.9, 1.8, and 3.6%, respectively. Predictors of in-hospital procedural success were type of access (OR 0.33, 95% CI 0.13-0.82, P = 0.017), prior coronary intervention (OR 5.3, 95% CI 1.20-23.41, P = 0.028) and pre-procedural Karnofsky index using univariate regression. Pre-procedural Karnofsky index emerged as the only independent predictor (OR 1.04, 95% CI 1.00-1.08, P = 0.032) in the multivariate analysis.


CONCLUSIONS
Pre-procedural functional performance status predicts the in-hospital outcome after TAVI. Patients with a good functional status are likely to benefit more from TAVI than previously reported high-risk patients.
Buellesfeld
Lutz
L
Department of Cardiology/Angiology, HELIOS Heart Center Siegburg, Ringstrasse 49, 53721 Siegburg, Germany. lub@gmx.com
Wenaweser
Peter
P
Gerckens
Ulrich
U
Mueller
Ralf
R
Sauren
Barthel
B
Latsios
Georg
G
Zickmann
Bernfried
B
Hellige
Gerrit
G
Windecker
Stephan
S
Grube
Eberhard
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D006328:Cardiac Catheterization / Q000379:methods*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult