Outcomes of Balloon-Expandable Transcatheter Aortic Valve Replacement in Younger Patients: Key Insights from a Registry Analysis
A recent analysis of 139,695 patients under 80 years old from the Society for Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (TVT) Registry sheds light on outcomes of balloon-expandable TAVR using the SAPIEN valve family, spanning August 2019 to September 2023.
The study explores a hypothesis: many younger patients with aortic stenosis may have significant comorbidities that limit life expectancy, reducing the need for repeat procedures. As a result, heart teams are thoughtfully balancing risks, benefits, and valve longevity when considering TAVR for younger patients with a shorter projected lifespan.
Comparing patients younger than 65 to those aged 65–80 years, the study examined:
Primary Outcomes: Mortality, stroke, and combined mortality or stroke were assessed in-hospital, at 30 days, and 1 year.
Secondary Outcomes: Cardiac death, life-threatening bleeding, major vascular issues, new pacemaker need, dialysis, atrial fibrillation onset, valve reintervention, and readmissions. Health status was evaluated using the Kansas City Cardiomyopathy Questionnaire (KCCQ).
Key Findings:
👉 Younger patients (<65 years) were more likely to have bicuspid aortic valves (25.2% vs. 7.6% in those 65–80; P < .001).
👉 Patients <65 years had higher 1-year readmission rates (28.2% vs. 26.1%; P < .001) and all-cause mortality (9.9% vs. 8.2%; P < .001).
👉 In propensity-matched comparisons, younger patients still had higher readmission rates at 1 year (28.2% vs. 26.8%; P < .03) and similar mortality to older patients (9.9% vs. 10.1%; P = .55).
Conclusion: Younger patients with TAVR often face a high comorbidity burden, experiencing higher death and readmission rates at 1 year compared to older counterparts. These outcomes suggest that current heart team decision-making for TAVR in younger patients is sound, emphasizing careful risk assessment and tailored patient counseling.
📖 Read the full study here: https://lnkd.in/dcTmhpeW
Mansoura University
EACTS - European Association for Cardio-Thoracic Surgery
European Society of Thoracic Surgeons
European Trauma Course Organisation
European Society of Cardiology
Journal Cardiothoracic Vascular Anesthesia
European Association of Cardiothoracic Surgery
European Society of Thoracic Surgeons
American Society of Anesthesiologists®
Society of Cardiovascular Anesthesiologists
EACTAIC - European Association of Cardiothoracic Anaesthesiology and Intensive Care
SATA Transplant Anesthesia
Seminars in Cardiothoracic and Vascular Anesthesia
@NEJM
JAMA
Outcomes of Balloon-Expandable TAVR in Younger Patients: Key Insights from a Registry Analysis
https://lnkd.in/dmwyBAui
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