- 作者：Mathieu Gautier ; Marion Pé ; pin ; Dominique Himbert ; Gré ; gory Ducrocq ; Bernard Iung ; David Attias ; Caroline Cueff De Monchy ; Jean-Michel Juliard ; Patrick Nataf ; Alec Vahanian
- 刊名：Archives of Cardiovascular Diseases Supplements
- 出版年：2011
- 出版时间：January 2011
- 年：2011
- 卷：3
- 期：1
- 页码：46
- 全文大小：49 K
Purpose
To describe the impact of coronary artery disease (CAD) on management of high-risk patients with aortic stenosis referred for transcatheter aortic valve implantation (TAVI).Methods
Of 240 patients referred for TAVI, 145 (60 % ) effectively underwent TAVI, while 31 (13 % ) were re oriented towards conventional surgery and 64 (27 % ) were conservatively managed. We compared the 147 patients (61 % ) with CAD with the 93 (39 % ) with no CAD.
Results
Patients with CAD presented with one or several of the following: previous myocardial infarction in 54 (37 % ), coronary artery bypass grafting (CABG) in 63 (43 % ), percutaneous coronary intervention (PCI) in 49 (33 % ). CAD was diagnosed during the screening for TAVI in 46 (31 % ). CAD led to re orient 5 patients (2 % ) towards conventional surgery for combined aortic valve replacement and CABG, and to perform PCI before TAVI in 9 (6 % ) or during the procedure in 2 (1 % ). No patient was denied any intervention because of CAD. The comparison between patients with and without CAD is detailed in the Table.
Conclusions
| Overall (n = 240) | CAD (n = 147) | no CAD (n = 93) | p | |
|---|---|---|---|---|
| Age (years) | 81 ¡À 8 | 81 ¡À 9 | 83 ¡À 7 | 0.07 |
| Female gender | 111 (46 % ) | 47 (32 % ) | 64 (69 % ) | <0.0001 |
| Carotid artery disease | 58 (24 % ) | 50 (34 % ) | 8 (9 % ) | <0.0001 |
| Renal failure | 89 (37 % ) | 63 (43 % ) | 26 (28 % ) | 0.03 |
| 2 comorbidities | 151 (63 % ) | 104 (71 % ) | 47 (50 % ) | 0.002 |
| EuroSCORE % | ( % ) 28 ¡À 16 | 31 ¡À 17 | 24 ¡À 12 | 0.001 |
| TAVI performed | 145 (60 % ) | 83 (56 % ) | 62 (67 % ) | 0.11 |
| TAVI procedural success | 141 (97 % ) | 81 (98 % ) | 60 (97 % ) | 0.76 |
| post-TAVI troponin (mcg/L) | 4.5 ¡À 0.6 | 5.2 ¡À 0.7 | 3.5 ¡À 0.9 | 0.07 |
| 30-day post TAVI survival ( % ) | 88 | 91 | 85 | 0.25 |
| 1-year post TAVI survival ( % ) | 74 ¡À 4 | 76 ¡À 5 | 71 ¡À 7 | 0.36 |
| NYHA I/II last follow-up ( % ) | 85 | 85 | 85 | 0.73 |