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Clinical outcomes of transcatheter aortic valve implantation in younger patients
Session:
Posters (Sessão 6 - Écran 8) - Intervenção Coronária e Estrutural 5 - Intervenção Valvular
Speaker:
Gualter Santos Silva
Congress:
CPC 2022
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Gualter Santos Silva; Mariana Silva; Cláudio Guerreiro; Pedro Teixeira; Pedro Queirós; Diogo Ferreira; Mariana Brandão; Fábio Nunes; Rafael Teixeira; Alberto Rodrigues; Pedro Braga; Ricardo Fontes-Carvalho
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Background:</strong> Currently, the European Society of Cardiology recommends TAVI for patients older than 75 years as a result of trials that demonstrate a non-inferiority in relation to SAVR. TAVI is also performed in younger patients, particularly in those unsuitable for surgery. However, the clinical outcomes in this subgroup of patients are still scarce. Concerns in relation about valve durability and pacemaker implantation acquire even more importance in younger patients.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Aim:</strong> The aim of the study was to describe the characteristics and the outcomes of TAVI in patients <75 years old.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods:</strong> Retrospective analysis of patients who underwent TAVI (n= 846) in a single centre between August 2007 and December 2020. All patients were stratified by age (</> 75 years) and baseline characteristics, complications of procedure and mortality were compared between the two groups.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong> Overall, 173 (20.4%) patients were < 75 years; the mean age was 68.7 ± 6.8 years. The younger patients were more often male (64.7 % vs 45.5%, p<0.001), had higher prevalence of diabetes (52.3% vs 35.3%, p<0.001), lung disease (30.7% vs 20.2%, p=0.017) and previous cardiac surgery (31.7% vs 16.3%, p<0.001), had lower mean LV ejection fraction (46.8±13.4% vs 52.3±11.5%, p<0.001) and STS score (4.2±4.4 vs 5.4±3.7) and had lower prevalence of atrial fibrillation (23.7% vs 34.0%, p=0.010). Regarding post-procedure complications, younger patients had lower incidence of acute kidney injury (11.0% vs 18.3%, p=0.027). There were no differences in rates of permanent pacemaker implantation, vascular complications and cerebral events. 30-day mortality was similar between two groups (5.7% vs 7.2%, p=0.730) and 1-year mortality was non-significant lower in younger patients (7.5% vs 11.4%, p=0.092).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion:</strong> Use of TAVI in younger patients will continue to increase. Our study showed that although patients were clinically different, the outcomes were similar between younger and older TAVI patients. <span style="background-color:white"><span style="color:black">Dedicated trials of TAVI/SAVR in younger patients are needed to guide decisions concerning expansion of TAVI indications.</span></span></span></span></p>
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