THE IMPACT OF TRANSCATHETER AORTIC VALVE REPLACEMENT ON CLINICAL OUTCOMES IN PATIENTS WITH NORMAL-FLOW LOW GRADIENT SEVERE AORTIC STENOSIS

Caleb Chiang; Mohamad Hemu; Jaafar Alward; Konstantinos Voudris; Hussam Suradi

doi:10.1016/S0735-1097(21)02345-7

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THE IMPACT OF TRANSCATHETER AORTIC VALVE REPLACEMENT ON CLINICAL OUTCOMES IN PATIENTS WITH NORMAL-FLOW LOW GRADIENT SEVERE AORTIC STENOSIS

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THE IMPACT OF TRANSCATHETER AORTIC VALVE REPLACEMENT ON CLINICAL OUTCOMES IN PATIENTS WITH NORMAL-FLOW LOW GRADIENT SEVERE AORTIC STENOSIS

Caleb Chiang, Mohamad Hemu, Jaafar Alward, Konstantinos Voudris and Hussam Suradi

Journal of the American College of Cardiology, Vol.77(18 Supplement 1), pp.986-986

05/11/2021

DOI: 10.1016/S0735-1097(21)02345-7

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Abstract

Background The optimal treatment of patients with normal-flow, low gradient severe aortic stenosis (NF-LG-SAS) who remain symptomatic despite medical therapy is debatable. This study's primary objective is to evaluate the impact of transcatheter aortic valve replacement (TAVR) on quality of life and adverse cardiovascular events in this population. Methods This single center, retrospective study analyzed patients with aortic valve area <1cm2, mean gradient <40 mmHg, and indexed stroke volume >35 mL/m2 who underwent TAVR between 2014-2019. Primary outcomes included functional status as determined by change in New York Heart Association (NYHA) class at 3-month follow up and one-year all-cause mortality. Secondary outcomes for one-year post TAVR included admission for heart failure exacerbation (AHF), acute coronary syndrome (ACS), new-onset atrial fibrillation, stroke, and permanent pacemaker (PPM) placement. Results A total of 29 patients (17.5% female, 79±10) met the criteria for NF-LG-SAS. 69% had NYHA class III and 14% had NYHA class IV. At 3-month follow up, 62.1% had NYHA class I and 37.9% had NYHA class II (p<0.001). One-year mortality rate was 12%. In secondary outcome analyses, 16% of patients had AHF and 4% required PPM. None of the patients had ACS, stroke, or atrial fibrillation. Conclusion Our study demonstrates that patient with NF-LG-SAS who remain symptomatic despite medical therapy could have significant improvement in functional status and overall quality of life after TAVR.

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Title: Subtitle: THE IMPACT OF TRANSCATHETER AORTIC VALVE REPLACEMENT ON CLINICAL OUTCOMES IN PATIENTS WITH NORMAL-FLOW LOW GRADIENT SEVERE AORTIC STENOSIS
Creators: Caleb Chiang - Rush University Medical Center
Mohamad Hemu - Rush University Medical Center
Jaafar Alward - Rush University Medical Center
Konstantinos Voudris - Rush University Medical Center
Hussam Suradi - Rush University Medical Center
Resource Type: Abstract
Publication Details: Journal of the American College of Cardiology, Vol.77(18 Supplement 1), pp.986-986
DOI: 10.1016/S0735-1097(21)02345-7
ISSN: 0735-1097
Language: English
Date published: 05/11/2021
Academic Unit: Internal Medicine
Record Identifier: 9985218629902771

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