Comparison of Outcomes of Transfemoral Aortic Valve Implantation in Patients <90 With Those >90 Years of Age
Section snippets
Methods
The Ethics Committee of the Academic Medical Centre (AMC) Amsterdam, the Netherlands, approved this research with a waiver. The population comprised all consecutive patients who underwent a transfemoral (TF)-TAVI with a balloon-expandable SAPIEN XT or SAPIEN 3 prosthesis (Edwards Lifesciences, Irvine, CA), between January 8, 2009, and February 28, 2017, in the AMC. The decision for TAVI treatment was made by our multidisciplinary TAVI team consisting of a cardiologist, a cardiac surgeon, a
Results
A total of 599 patients underwent TF-TAVI with the SAPIEN XT of SAPIEN 3. Of these patients 47 (8%) were nonagenarians (Table 1). There were relatively more females in the nonagenarian group and they had fewer risk factors (diabetes, smoking, declined renal function) and fewer co-morbidities (less previous coronary artery bypass, previous strokes, chronic obstructive pulmonary disease). Nonagenarians had a higher mean estimated postoperative mortality compared with the controls. Of the 47
Discussion
Our study shows that nonagenarian patients have very acceptable procedural and mid-term results compared with younger controls, when treated with TF-TAVI. Several earlier studies have shown that TAVI is feasible and safe in nonagenarians,6, 8, 16, 17, 18, 19 a finding that we have confirmed in our study. In the current literature, 30-day mortality varies from 3.2% to 12.0%, depending on the access route used. We found an even lower 30-day mortality of 2.1% in our patients who were treated
Disclosures
Dr. Baan receives an unrestricted research grant from Edwards Lifesciences and is a proctor for Edwards Lifesciences.
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The first affiliation is part of the Amsterdam Cardiovascular Sciences.