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Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
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Characteristics and outcomes of very old patients who underwent TAVI-experience of a tertiary center
Session:
Painel 10-Doença Valvular 2
Speaker:
Tânia Proença
Congress:
CPC 2020
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.4 Valvular Heart Disease – Treatment
Session Type:
Posters
FP Number:
---
Authors:
Tânia Proença; Miguel Martins De Carvalho; Ricardo Alves Pinto; Pedro Grilo Diogo; Sofia Torres; Carlos Xavier Resende; Paulo Maia Araújo; Alzira Nunes; Roberto Pinto; Ricardo Lopes; Domingos Magalhães; Rui André Rodrigues; JOAO SILVA; Filipe Macedo; Maria Júlia Maciel Barbosa
Abstract
<p>Introduction: Transcatheter aortic valve implantation (TAVI) is an established procedure to treat patients with severe aortic stenosis. Older age has been linked to an increased risk of operative mortality. In elderly patients, TAVI is a possible alternative that has been shown to be feasible.</p> <p>Purpose: To evaluate a subgroup of very old patients who underwent TAVI and compare with all sample.</p> <p>Methods: We retrospectively analyzed a subgroup of very old patients who underwent TAVI from October 2014 to June 2018.Clinical features were collected and compared with other patients submitted to TAVI in that same center. Very old patients were defined has being older than 85 year-old, inclusive. To evaluate cardiovascular outcomes, we used major adverse cardiovascular events (MACE), defined as cardiovascular death, myocardial infarction or ischemic stroke at 6 months follow-up.</p> <p>Results: Of our population of 214 patients, 64 were selected for this subgroup analyses, having a mean age of 87 ± 2,72 year-old. This subgroup had a lower prevalence of cardiovascular risk factors: hypertension (78,1 vs 85%), dyslipidemia (57,8 vs 70%) and diabetes (26,6% vs 36%). Conversely, the prevalence of chronic kidney disease (defined as eGFR<60 mL/min/1,73m2) was higher than the general population (85,9% vs 67%) with a mean eGFR significantly different (43 vs 55 mL/min/1,73m2, p<0.001). Atrial fibrillation was also higher, but not statistically different (37,5 vs 35%). As of previous cardiovascular history, this subgroup had a much lower incidence of previous heart surgery (6,3 vs 30%), including CABG (4,7 vs 16%); the prevalence of obstructive coronary artery disease was slightly lower (56,2 vs 61%), as was the incident of previous acute coronary syndrome (26,6 vs 23%). The prevalence of previous acute cerebrovascular disease was higher (23,4 vs 19%). Comparing with younger patients, very old patients had a tendency of higher rate of pacemaker implantation (23.4 vs 18%, p=0.359), MACE (17.2 vs 10.7%, p=0.188) and all-cause mortality (12.5 vs 8.0 %, p=0.300) at a follow-up of 6 months.</p> <p>Conclusion: Very old patients that underwent TAVI had a lower prevalence of cardiovascular risk factors and lower rates of previous cardiac interventions at presentation. However, our sample showed that these populations tends to have higher risk of complications, MACE and all-cause mortality, although it has not reached statistical significance.</p>
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