In-hospital and mid-term predictors of mortality after transcatheter aortic valve implantation: data from the TAVI National Registry 2010-2011.
OBJECTIVE
The treatment of severe symptomatic aortic stenosis has been revolutionized by the technique of transcatheter valve replacement. The purpose of this study was to present the outcomes and predictors of mortality in patients enrolled between 2010 and 2011 in the Transcatheter Aortic Valve Replacement National Registry.


METHODS
We collected 131 preprocedural, 31 periprocedural, and 76 follow-up variables, and analyzed the immediate implant success rate, the 30-day safety endpoint, and all-cause 30-day and mid-term (mean follow-up, 244 days) mortality.


RESULTS
From January 2010 to December 2011, a total of 1416 patients were included: 806 with Edwards valves and 610 with CoreValves. The implant success and 30-day mortality rates were 94% and 8%, respectively, without differences between types of valves and approaches. The 30-day safety endpoint and mid-term mortality rates were 14% and 16%, respectively, which were also similar between groups. The presence of comorbidities (renal failure, peripheral vascular disease, ejection fraction, and atrial fibrillation), the need for conversion to surgery, and at least moderate aortic regurgitation after transcatheter aortic valve implantation were identified as independent predictors of in-hospital and mid-term mortality.


CONCLUSIONS
The prognosis of valve implant patients could be improved by including comorbidities in patient selection and by minimizing the degree of residual aortic regurgitation to optimize the results of the procedure.
On behalf of the Working Group on Cardiac Catheterization and Interventional Cardiology (Sección de Hemodinámica y Cardiología Intervencionista) of the Spanish Society of Cardiology (Sociedad Española de Cardiología); Hospital Universitari Clínic, IDIBAPS, Barcelona, Spain. Electronic address: masabate@clinic.ub.es.
Manel
M
Sabaté
On behalf of the Spanish Society of Thoracic-Cardiovascular Surgery (Sociedad de Cirugía Torácica-Cardiovascular); Servicio de Cirugía Cardiaca, Hospital General Universitario de Valencia, Valencia, Spain.
Sergio
S
Cánovas
Servicio de Cardiología; Unidad de Cardiología Intervencionista y Servicio de Cirugía Cardiaca, Hospital Universitario Clínico San Carlos, Madrid, Spain.
Eulogio
E
García
Servicio de Cardiología; Unidad de Cardiología Intervencionista y Servicio de Cirugía Cardiaca, Hospital Universitario Clínico San Carlos, Madrid, Spain.
Rosana
R
Hernández Antolín
Servicio de Cardiología; Unidad de Cardiología Intervencionista y Servicio de Cirugía Cardiaca, Hospital Universitario Clínico San Carlos, Madrid, Spain.
Luis
L
Maroto
Servicio de Cardiología, Hospital Clínico Virgen de la Victoria, Málaga, Spain.
José María
JM
Hernández
Servicio de Cardiología, Hospital Clínico Virgen de la Victoria, Málaga, Spain.
Juan H
JH
Alonso Briales
Servicio de Cardiología, Hospital Clínico Virgen de la Victoria, Málaga, Spain.
Antonio J
AJ
Muñoz García
Servicio de Cardiología; Unidad de Cardiología Intervencionista y Servicio de Cirugía Cardiaca, Hospital Gregorio Marañón, Madrid, Spain.
Enrique
E
Gutiérrez-Ibañes
Servicio de Cardiología; Unidad de Cardiología Intervencionista y Servicio de Cirugía Cardiaca, Hospital Gregorio Marañón, Madrid, Spain.
Jorge
J
Rodríguez-Roda
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D002423:Cause of Death; D005260:Female; D006350:Heart Valve Prosthesis; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012042:Registries; D018570:Risk Assessment; D013030:Spain; D013997:Time Factors; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods / Q000401:mortality*; D014463:Ultrasonography
Aortic stenosis; Estenosis aórtica; Implantación de válvula aórtica transcatéter; Registro; Registry; TAVI; Transcatheter aortic valve implantation; transcatheter aortic valve implantation