Outcomes of Transcatheter Aortic Valve Implantation in Nonagenarians Compared to Younger than 90 Year Old Patients - Université Toulouse III - Paul Sabatier - Toulouse INP Accéder directement au contenu
Article Dans Une Revue The American Journal of Medicine Année : 2022

Outcomes of Transcatheter Aortic Valve Implantation in Nonagenarians Compared to Younger than 90 Year Old Patients

Résumé

Background: Given that life expectancy has improved, nonagenarians have become a significant proportion of world population. As aortic stenosis is primarily a disease of the elderly, the need for invasive cardiac approaches is expected to increase in people of extreme age. Herein, we compare the in-hospital adverse clinical outcomes and mortality after transcatheter aortic valve implantation (TAVI) procedures in nonagenarians to younger than 90 year old patients. Methods: A retrospective study was conducted on 1336 patients who underwent TAVI between January 2016 and March 2020 at Toulouse University Hospital, Rangueil, France. Post-TAVI adverse clinical outcomes were defined according to Valve Academic Research Consortium-2 Criteria. The studied population was divided into 2 groups according to age. Results: Out of 1336 patients, 250 (18.7%) were nonagenarians with a mean age of 91.8 ± 1.9 years. Pacemaker implantation (12.4% vs 12.1%), stroke (2% vs 1.8%), and major vascular complications (9.2% vs 6.7%) were more common in nonagenarians, whereas acute kidney injury (1.2% vs 2.7%) and major bleeding events (3.2% vs 3.4%) were more common in the <90-year-old group. Nonagenarians are more likely to develop major vascular complications (odds ratio [OR] = 1.76 95% confidence interval [CI] 1.04-3, P = .03). The prevalence of in-hospital mortality in nonagenarians and <90-year-old patients were 5.2% and 2%, respectively. Survival analysis showed a significant difference in mortality during hospitalization period only ( P = .04). Conclusion: The prevalence of TAVI procedural success is remarkably high in nonagenarians and comparable to that of younger patients. However, the in-hospital mortality rate was 2-fold more than that of <90-year-old patients.

Dates et versions

hal-04469445 , version 1 (20-02-2024)

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Anthony Matta, Thibault Lhermusier, Fréderic Bouisset, Francisco-Campelo Parada, Meyer Elbaz, et al.. Outcomes of Transcatheter Aortic Valve Implantation in Nonagenarians Compared to Younger than 90 Year Old Patients. The American Journal of Medicine, 2022, 135 (6), pp.745-751. ⟨10.1016/j.amjmed.2022.02.024⟩. ⟨hal-04469445⟩
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