Early mortality and safety after transcatheter aortic valve replacement using the SAPIEN 3 in nonagenarians

Eiji Ichimoto, Adam Arnofsky, Michael Wilderman, Richard Goldweit, Joseph De Gregorio

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Objective: Transcatheter aortic valve replacement (TAVR) has been performed for many elderly patients with severe aortic stenosis (AS). The SAPIEN 3 is one of the latest balloon-expandable prosthesis. This study aimed to investigate the early clinical outcomes after TAVR using the SAPIEN 3 in nonagenarians. Methods: A total of 97 consecutive patients underwent TAVR for severe AS between December 2015 and December 2016. Of these, 85 consecutive patients who underwent TAVR using the SAPIEN 3 were included. According to the age, patients were classified into age ≥90 years group (17 patients) or age <90 years group (68 patients). The clinical outcomes including all-cause mortality and composite endpoint of early safety at 30 days were evaluated. Results: The Society of Thoracic Surgeons score in age ≥90 years group was higher than age <90 years group (12.3 ± 6.1% vs. 8.5 ± 5.1%, P<0.01). There was no significant difference in 30-day mortality between 2 groups. However, the life-threatening bleeding and major vascular complications in age ≥90 years group were greater than age <90 years group (11.8% vs. 1.5%, P=0.04 and 11.8% vs. 1.5%, P=0.04, respectively). The composite endpoint of early safety at 30 days was similar between 2 groups. Multivariate logistic regression analysis showed that prior myocardial infarction was an independent predictor of the composite endpoint of early safety (odds ratio 4.76, 95% confidence interval 1.02 to 22.21, P=0.047). Conclusions: The early mortality and safety after TAVR using the SAPIEN 3 in nonagenarians were similar and acceptable despite of higher operative risk.

Original languageEnglish
Pages (from-to)387-393
Number of pages7
JournalJournal of Geriatric Cardiology
Volume15
Issue number6
StatePublished - 2018
Externally publishedYes

Keywords

  • Nonagenarians
  • The SAPIEN 3
  • Transcatheter aortic valve replacement

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