Transcatheter aortic valve implantation (TAVI) is rapidly evolving in Germany. Especially
severe reduced left ventricular ejection fraction (LVEF) is known as a prominent risk
factor for adverse outcome in open heart surgery. Thus, the data of the prospective
multicenter German Transcatheter Aortic Valve Interventions Registry were analyzed
for outcomes in patients with severe depressed LVEF. Data of 1,432 patients were consecutively
collected after transcatheter aortic valve implantation. Patients were divided into
2 groups (A: LVEF ≤30%, n = 169, age 79.9 ± 6.7 years, logES 34.2 ± 17.8%; B: LVEF
>30%, n = 1,263, age 82.0 ± 6.1 years, logES 18.9 ± 12.0%), and procedural success
rates, New York Heart Association classification, and quality of life were compared
at 30 days and 1 year, respectively. Technical success was achieved in 95.9% (A) and
97.6% (B). Survival and the New York Heart Association classification at 30 days demonstrated
an excellent outcome in both groups. There was a significant improvement according
to the self-assessment in health condition (0 to 100 scale) with a much larger gain
in group A (28 vs 19 patients, p <0.0001). Nevertheless, low cardiac output syndrome
(12.3% vs 5.9%, p <0.01) and resuscitation (10.4% vs 5.6%, p <0.05) were more frequently
seen in group A, contributing to a higher mortality at 30 days (14.3% vs 7.2%) and
1 year (33.7% vs 18.1%, p <0.001). In conclusion, this real-world registry demonstrated
a comparably high success rate for patients with severe reduced LVEF and an early
improvement in functional status as demonstrated by substantial benefit, despite a
doubled postprocedural mortality.
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Article info
Publication history
Published online: December 17, 2014
Accepted:
December 1,
2014
Received in revised form:
December 1,
2014
Received:
July 7,
2014
Footnotes
See page 662 for disclosure information.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
