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30-day and 1-year mortality after transcatheter aortic valve replacement: the impact of balloon aortic valvuloplasty as a bridging therapy in a tertiary center
Session:
Sessão de Posters 08 - Intervenção estrutural: TAVI
Speaker:
Francisco Barbas de Albuquerque
Congress:
CPC 2024
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Cartazes
FP Number:
---
Authors:
Francisco Barbas De Albuquerque; Bárbara Lacerda Teixeira; André Grazina; Rúben Ramos; António Fiarresga; Alexandra Castelo; Tiago Mendonça; Inês Rodrigues; Duarte Cacela; Rui Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Introduction: </strong>Since the advent and development of transcatheter aortic valve replacement (TAVR) in contemporary era, balloon aortic valvuloplasty (BAV) has seen renewed interest. We aimed to compare 30-day and 1-year all-cause mortality between patients submitted to BAV as a bridging therapy before definite TAVR and patients submitted directly to TAVR. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Methods: </strong>This was an observational, retrospective study of patients who underwent TAVR between 2009 and 2022 in a tertiary center. Patients with severe aortic stenosis (SAS) who underwent TAVR without prior BAV (woBAV group) and patients who were performed TAVR with prior BAV (wBAV group) as a bridging therapy were included. Primary endpoint was all-cause mortality at 30 days and 1 year after TAVR between wBAV and woBAV groups.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Results:</strong> 800 patients were included, of which 767 were in woBAV group and 33 were in wBAV group. 30-day all-cause mortality rate was 21% in wBAV group compared to 4.4% in woBAV (unadjusted hazard ratio [HR], 5.19; 95% confidence interval [CI], 2.3 – 11.7, p<0.001). At 1-year, all-cause mortality rate was 27% in wBAV group compared to 12% in woBAV group (unadjusted HR, 2.55; 95% CI, 1.28-5.10, p=0.007). After covariate adjustments, mortality remained significantly higher in wBAV group (Figure 1).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Conclusion: </strong></span></span><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif">Our study provides valuable insights into the outcomes of patients undergoing TAVR with prior BAV as bridging therapy, as these patients have higher mortality at 30 days and 1 year comparing to their counterparts. This underscores the importance of meticulous patient selection when considering BAV as bridging therapy, since this technique still has a role in contemporary TAVR era.</span></span></p>
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