Outcomes of emergency transcatheter aortic valve replacement in patients with cardiogenic shock: A multicenter retrospective study.
Aortic Valve
/ diagnostic imaging
Aortic Valve Stenosis
/ complications
Arrhythmias, Cardiac
Bundle-Branch Block
/ etiology
Heart Valve Prosthesis
/ adverse effects
Humans
Quality of Life
Retrospective Studies
Risk Factors
Shock, Cardiogenic
/ diagnosis
Stroke Volume
Transcatheter Aortic Valve Replacement
Treatment Outcome
Ventricular Function, Left
aortic valve stenosis
bundle-branch block
cardiac resynchronization therapy
critical care
percutaneous aortic valve replacement
Journal
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X
Titre abrégé: Catheter Cardiovasc Interv
Pays: United States
ID NLM: 100884139
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
received:
20
02
2022
accepted:
28
03
2022
pubmed:
9
4
2022
medline:
10
6
2022
entrez:
8
4
2022
Statut:
ppublish
Résumé
Rescue transcatheter aortic valve replacement (TAVR) in patients with cardiogenic shock is challenging, and there is limited literature on these critical patients. The aim of this study was to determine the characteristics and outcomes of patients undergoing TAVR, feasibility and safety of the procedure, and 1-year mortality factors. Thirty-eight patients with severe aortic disease and cardiogenic shock admitted to two French hospitals from 2015 to 2019 were included. The patients were critical, 78.9% of them had a left ventricular ejection fraction of <30%, and all of them received inotropic support. "Valve-in-valve" procedures were performed in 15.8% and 13.2% underwent balloon aortic valvuloplasty before TAVR. Edwards Sapien3® and Medtronic CoreValve EvolutR® were used. The survival probability remained reasonable for patients with cardiogenic shock who underwent rescue TAVR. The 30-day mortality rate was 7.9% and 21.1% at 1 year. No patient died during the intervention. The procedure was safe, with few complications except for acute kidney failure, the development of a left bundle branch block, and the need for pacemaker implantation. Both functional and echocardiographic results were good at 1 year, although 29% of the patients underwent rehospitalization within 1 year. The development of a left bundle branch block was found to be a mortality risk factor. This procedure is a safe and effective therapy with acceptable survivorship in critically ill patients. The benefits to their quality of life should be evaluated in future studies, and the need for providing early cardiac resynchronization therapy must be emphasized.
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
2117-2124Informations de copyright
© 2022 Wiley Periodicals LLC.
Références
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