PMID- 33028765
OWN - NLM
STAT- MEDLINE
DCOM- 20210414
LR  - 20210414
IS  - 1349-7235 (Electronic)
IS  - 0918-2918 (Print)
IS  - 0918-2918 (Linking)
VI  - 60
IP  - 4
DP  - 2021 Feb 15
TI  - The Prognosis of Elderly Patients with Aortic Stenosis after Transcatheter Aortic 
      Valve Replacement.
PG  - 517-523
LID - 10.2169/internalmedicine.5047-20 [doi]
AB  - Objective Aortic stenosis (AS) is common among elderly patients. Since 
      transcatheter aortic valve replacement (TAVR) is a less invasive procedure than 
      surgical aortic valve replacement for symptomatic severe AS, super-elderly 
      patients have tended to undergo TAVR. We retrospectively investigated the 
      post-TAVR outcome in super-elderly patients with severe AS. Methods This analysis 
      included 433 patients who underwent TAVR in the University of Wisconsin Hospital 
      and Clinics from 2012 to 2017. Post-TAVR mortality, complications in-hospital, 
      rehospitalization, the New York Heart Association (NYHA) functional class and 
      echocardiographic parameters were compared between patients <85 years old (n = 
      290) and >/=85 years old (n = 143). Results The patients >/=85 years old less 
      frequently had a history of coronary artery disease (73.1% vs. 62.2%, p=0.026) 
      and hypertension (87.2% vs. 77.6%, p=0.012) than younger patients. Furthermore, 
      the patients >/=85 years old had moderate-severe mitral regurgitation more 
      frequently (19.3% vs. 28.7%, p=0.037) at baseline than younger patients. There 
      was no significant difference in in-hospital outcomes between the age groups. The 
      30-day mortality was worse in patients >/=85 years old than in younger ones (0.7% 
      vs. 3.5%, p=0.042). While there was no significant difference in the long-term 
      mortality between the 2 groups, the estimated 1-year mortality from Kaplan-Meier 
      curves were 9.6% in patients <85 years old and 14.9% in patients >/=85 years old. 
      The rate of in-hospital complications, rehospitalization rate, improvement in the 
      NYHA functional class and echocardiographic parameters were comparable between 
      the two groups. Conclusion The outcomes of super-elderly patients after TAVR were 
      acceptable, suggesting that these patients could benefit from TAVR.
FAU - Saito, Yukihiro
AU  - Saito Y
AD  - Department of Medicine, University of Wisconsin School of Medicine and Public 
      Health, USA.
FAU - Lewis, Erik E
AU  - Lewis EE
AD  - Department of Surgery, University of Wisconsin School of Medicine and Public 
      Health, USA.
FAU - Raval, Amish
AU  - Raval A
AD  - Department of Medicine, University of Wisconsin School of Medicine and Public 
      Health, USA.
FAU - Gimelli, Giorgio
AU  - Gimelli G
AD  - Department of Medicine, University of Wisconsin School of Medicine and Public 
      Health, USA.
FAU - Jacobson, Kurt M
AU  - Jacobson KM
AD  - Department of Medicine, University of Wisconsin School of Medicine and Public 
      Health, USA.
FAU - Osaki, Satoru
AU  - Osaki S
AD  - Department of Surgery, University of Wisconsin School of Medicine and Public 
      Health, USA.
LA  - eng
PT  - Journal Article
DEP - 20201007
PL  - Japan
TA  - Intern Med
JT  - Internal medicine (Tokyo, Japan)
JID - 9204241
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve/surgery
MH  - *Aortic Valve Stenosis/diagnostic imaging/surgery
MH  - *Heart Valve Prosthesis Implantation/adverse effects
MH  - Humans
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - *Transcatheter Aortic Valve Replacement/adverse effects
MH  - Treatment Outcome
PMC - PMC7946496
OTO - NOTNLM
OT  - TAVR
OT  - severe AS
COIS- The authors state that they have no Conflict of Interest (COI).
EDAT- 2020/10/09 06:00
MHDA- 2021/04/15 06:00
PMCR- 2021/02/15
CRDT- 2020/10/08 05:27
PHST- 2020/10/09 06:00 [pubmed]
PHST- 2021/04/15 06:00 [medline]
PHST- 2020/10/08 05:27 [entrez]
PHST- 2021/02/15 00:00 [pmc-release]
AID - 10.2169/internalmedicine.5047-20 [doi]
PST - ppublish
SO  - Intern Med. 2021 Feb 15;60(4):517-523. doi: 10.2169/internalmedicine.5047-20. 
      Epub 2020 Oct 7.