Conflict of interest: Dr de Jaegere is a proctor for Medtronic Corevalve.
E-ONLY: Valvular and Structural Heart Diseases
Cause of death after transcatheter aortic valve implantation
Article first published online: 30 NOV 2013
Copyright © 2012 Wiley Periodicals, Inc., a Wiley company
Catheterization and Cardiovascular Interventions
Volume 83, Issue 7, pages E277–E282, 1 June 2014
How to Cite
Van Mieghem, N. M., van der Boon, R. M., Nuis, R.-J., Schultz, C., van Geuns, R.-J., Serruys, P. W., Kappetein, A.-P., van Domburg, R. T. and de Jaegere, P. P. (2014), Cause of death after transcatheter aortic valve implantation. Cathet. Cardiovasc. Intervent., 83: E277–E282. doi: 10.1002/ccd.24597
- Issue published online: 17 MAY 2014
- Article first published online: 30 NOV 2013
- Accepted manuscript online: 6 AUG 2012 05:29AM EST
- Manuscript Accepted: 30 JUL 2012
- Manuscript Revised: 18 JUL 2012
- Manuscript Received: 10 JUL 2012
- Valvular heart disease;
- aortic stenosis;
- cause of death
To evaluate survival and cause of death in a consecutive patient cohort undergoing Transcatheter Aortic Valve implantation (TAVI).
TAVI is a valid treatment option in patients with severe Aortic Stenosis (AS) who are deemed at (very) high operative risk. Because of (non-)cardiac comorbidities life expectancy in this patient, population is reduced when compared with the general population.
Consecutive patients with symptomatic aortic stenosis undergoing TAVI between November 2005 and December 2011 were included. (1) Survival status was obtained from the Dutch Civil Registry, (2) cause of death was derived by reviewing hospital charts, and (3) contacting referring physicians and patients' general practitioners.
Two hundred and thirty-seven consecutive patients were included with an overall all-cause mortality of 31% at a median follow up of 13 months (IQR 2–24 months). Four patients (1.6%) died < 48 hr of the TAVI procedure, and another 16 patients died up to the 30-day interval representing an all-cause 8.4% 30-day mortality. Between 30 days and 1-year another 30 patients died. Twenty-four patients died >1 year post TAVI. The predominant cause of death >48 hr post TAVI was noncardiac. One third of these deaths were due to sepsis/infection, one-fifth to cancer and stroke in 16%.
In our series of AS patients undergoing TAVI, the cause of death >48 hr post procedure was predominantly noncardiac at every time interval. Mortality was driven by sepsis/infection, cancer, and stroke. Rigorous patient selection may improve outcome after TAVI. © 2013 Wiley Periodicals, Inc.