title: Transcatheter Aortic Valve Implantation and Morbidity and Mortality-Related Factors: a 5-Year Experience in Brazil.
abstract: BACKGROUND
  Transcatheter aortic valve implantation has become an option for high-surgical-risk patients with aortic valve disease.
  
  
  OBJECTIVE
  To evaluate the in-hospital and one-year follow-up outcomes of transcatheter aortic valve implantation.
  
  
  METHODS
  Prospective cohort study of transcatheter aortic valve implantation cases from July 2009 to February 2015. Analysis of clinical and procedural variables, correlating them with in-hospital and one-year mortality.
  
  
  RESULTS
  A total of 136 patients with a mean age of 83 years (80-87) underwent heart valve implantation; of these, 49% were women, 131 (96.3%) had aortic stenosis, one (0.7%) had aortic regurgitation and four (2.9%) had prosthetic valve dysfunction. NYHA functional class was III or IV in 129 cases (94.8%). The baseline orifice area was 0.67 ± 0.17 cm2 and the mean left ventricular-aortic pressure gradient was 47.3±18.2 mmHg, with an STS score of 9.3% (4.8%-22.3%). The prostheses implanted were self-expanding in 97% of cases. Perioperative mortality was 1.5%; 30-day mortality, 5.9%; in-hospital mortality, 8.1%; and one-year mortality, 15.5%. Blood transfusion (relative risk of 54; p = 0.0003) and pulmonary arterial hypertension (relative risk of 5.3; p = 0.036) were predictive of in-hospital mortality. Peak C-reactive protein (relative risk of 1.8; p = 0.013) and blood transfusion (relative risk of 8.3; p = 0.0009) were predictive of 1-year mortality. At 30 days, 97% of patients were in NYHA functional class I/II; at one year, this figure reached 96%.
  
  
  CONCLUSIONS
  Transcatheter aortic valve implantation was performed with a high success rate and low mortality. Blood transfusion was associated with higher in-hospital and one-year mortality. Peak C-reactive protein was associated with one-year mortality.
authors.affiliation: Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brazil.
authors.forename: André Luiz Silveira
authors.initials: AL
authors.lastname: Souza
authors.affiliation: Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brazil.
authors.forename: Constantino González
authors.initials: CG
authors.lastname: Salgado
authors.affiliation: Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brazil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Mourilhe-Rocha
authors.affiliation: Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brazil.
authors.forename: Evandro Tinoco
authors.initials: ET
authors.lastname: Mesquita
authors.affiliation: Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brazil.
authors.forename: Luciana Cristina Lima Correia
authors.initials: LC
authors.lastname: Lima
authors.affiliation: Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brazil.
authors.forename: Nelson Durval Ferreira Gomes de
authors.initials: ND
authors.lastname: Mattos
authors.affiliation: Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brazil.
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Rabischoffsky
authors.affiliation: Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brazil.
authors.forename: Francisco Eduardo Sampaio
authors.initials: FE
authors.lastname: Fagundes
authors.affiliation: Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brazil.
authors.forename: Alexandre Siciliano
authors.initials: AS
authors.lastname: Colafranceschi
authors.affiliation: Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brazil.
authors.forename: Luiz Antonio Ferreira
authors.initials: LA
authors.lastname: Carvalho
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000453:epidemiology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000453:epidemiology / Q000601:surgery*; D001938:Brazil / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000401:mortality; D013997:Time Factors; D065467:Transcatheter Aortic Valve Replacement / Q000401:mortality*