Heart failure hospitalization following surgical or transcatheter aortic valve implantation in low-risk aortic stenosis

Aims: In low-risk patients with severe aortic stenosis (AS), sutureless surgical aortic valve replacement (SU-SAVR) may be an alternative to transcatheter aortic valve implantation (TAVI). The risk of heart failure hospitalization (HFH) after aortic valve replacement (AVR) in this population is inco...

Descripción completa

Detalles Bibliográficos
Autores: Lopez-Martinez, Helena|||0000-0002-0963-0207, Vilalta, Victoria|||0000-0003-1767-5963, Farjat-Pasos, J., Ferrer-Sistach, Elena|||0000-0002-1795-2193, Mohammadi, S., Escabia, Claudia|||0000-0002-8076-3539, Kalavrouziotis, D., Resta, Helena|||0000-0001-7323-5589, Borrellas, Andrea, Dumont, E., Carrillo, Xavier|||0000-0001-6691-8859, Paradis, J.M., Fernandez-Nofrerias, Eduard|||0000-0003-2219-921X, Delgado, Victoria|||0000-0002-9841-2737, Rodés-Cabau, J., Bayés-Genís, Antoni|||0000-0002-3044-197X
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:311655
Acceso en línea:https://ddd.uab.cat/record/311655
https://dx.doi.org/urn:doi:10.1002/ehf2.14887
Access Level:acceso abierto
Palabra clave:Aortic stenosis cardiomyopathy
Aortic valve stenosis
Heart failure
Mortality
Prostheses and implants
Descripción
Sumario:Aims: In low-risk patients with severe aortic stenosis (AS), sutureless surgical aortic valve replacement (SU-SAVR) may be an alternative to transcatheter aortic valve implantation (TAVI). The risk of heart failure hospitalization (HFH) after aortic valve replacement (AVR) in this population is incompletely characterized. This study aims to investigate the incidence, predictors, and outcomes of HFH in patients undergoing SU-SAVR versus TAVI. Methods and results: Patients referred for AVR between 2013 and 2020 at two centres were consecutively included. The decision for SU-SAVR or TAVI was determined by a multidisciplinary Heart Team. Cox regression and competing risk analysis were conducted to assess adverse events. Of 594 patients (mean age 77.5 ± 6.4, 59.8% male), 424 underwent SU-SAVR, while 170 underwent TAVI. Following a mean follow-up of 34.1 ± 23.1 months, HFH occurred in 112 (27.8%) SU-SAVR patients and in 8 (4.8%) TAVI patients (P < 0.001). The SU-SAVR cohort exhibited higher all-cause mortality (138 [32.5%] patients compared with 30 [17.6%] in the TAVI cohort [P < 0.001]). These differences remained significant after sensitivity analyses with 1:1 propensity score matching for baseline variables. SU-SAVR with HFH was associated with increased all-cause mortality (61.6% vs. 23.1%, P < 0.001). Independent associates of HFH in SU-SAVR patients included diabetes, atrial fibrillation, chronic obstructive pulmonary disease, lower glomerular filtration rate and lower left ventricular ejection fraction. SU-SAVR patients with HFH had a 12-month LVEF of 59.4 ± 12.7. Conclusions: In low-risk AS, SU-SAVR is associated with a higher risk of HFH and all-cause mortality compared to TAVI. In patients with severe AS candidate to SU-SAVR or TAVI, TAVI may be the preferred intervention.

Similares en LA Referencia