title: Comparison of Outcome of Transcatheter Aortic Valve Implantation With Versus Without Previous Coronary Artery Bypass Grafting (from the FRANCE 2 Registry).
abstract: Previous coronary artery bypass grafting (CABG) increases operative risk in conventional valve replacement. Transcatheter aortic valve implantation (TAVI) has been shown to be successful in high-risk patient subgroups. The present study compared outcome and overall survival in patients who underwent TAVI with and without history of CABG. From January 2010 to December 2011, 683 of the 3,761 patients selected for TAVI in 34 French centers (18%) had a history of CABG. Outcomes (mortality and complications) were collected prospectively according to the Valve Academic Research Consortium (VARC) criteria. Patients with previous CABG were younger, with higher rates of diabetes and vascular disease and higher logistic European System for Cardiac Operative Risk Evaluation (29.8 ± 16.4 vs 20.1 ± 13.0, p <0.001) but lower rates of pulmonary disease. Two types of valve (Edwards SAPIEN and Medtronic CoreValve) were implanted in equal proportions in the 2 groups. The 30-day and 1-year mortality rates from all causes on Kaplan-Meier analysis (9.2% vs 9.7%, p = 0.71; and 19.0% vs 20.2%, p = 0.49, respectively) did not differ according to the history of CABG. There were no significant differences in the Valve Academic Research Consortium complications (myocardial infarction, stroke or vascular, and bleeding complications). On multivariate analysis, CABG was not associated with greater 1-year post-TAVI mortality. In conclusion, previous CABG did not adversely affect outcome in patients who underwent TAVI, which may be an alternative to surgery in high-risk patients with severe aortic stenosis and history of CABG.
authors.affiliation: Department of Cardiology, Brest University, Brest, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Castellant
authors.affiliation: Department of Cardiology, Brest University, Brest, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Didier
authors.affiliation: Department of Cardiology, Brest University, Brest, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Bezon
authors.affiliation: Department of Cardiology, Brest University, Brest, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Couturaud
authors.affiliation: Department of Cardiology, Rouen University, Rouen, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Eltchaninoff
authors.affiliation: Department of Cardiology, Bichat University, Paris, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Iung
authors.affiliation: Department of Cardiac Surgery, Massy Hospital, Massy, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Donzeau-Gouge
authors.affiliation: UMR 1123, Creteil University, Creteil, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Chevreul
authors.affiliation: Department of Cardiology, Pasteur Hospital, Toulouse, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Fajadet
authors.affiliation: Department of Cardiology, Pasteur Hospital, Toulouse, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Leprince
authors.affiliation: Department of Cardiology, Rennes University, Rennes, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Leguerrier
authors.affiliation: UMR CNRS 5558, Lyon University, Lyon, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Lievre
authors.affiliation: Departement of Cardiac Surgery, Lille University, Lille, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Prat
authors.affiliation: UMR 1123, Creteil University, Creteil, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Teiger
authors.affiliation: Departement of Cardiac Surgery, Limoges University, Limoges, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Laskar
authors.affiliation: Department of Cardiology, Brest University, Brest, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Boschat
authors.affiliation: Department of Cardiology, Brest University, Brest, France. Electronic address: martine.gilard@chu-brest.fr.
authors.forename: Martine
authors.initials: M
authors.lastname: Gilard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000453:epidemiology / Q000601:surgery*; D006328:Cardiac Catheterization; D015897:Comorbidity / Q000639:trends; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*; D016896:Treatment Outcome