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Clinical outcomes with transcatheter aortic valve implantation at a single cardiac center in Saudi Arabia.

ABSTRACT: Transcatheter aortic valve implantation (TAVI) has been recognized as a valid alternative to surgery for severe aortic valve stenosis (AS) in high-risk surgical patients.Determine first-year clinical outcomes for TAVI at Madinah Cardiac Center (MMC) in Saudi Arabia.Retrospective, analytical cross-sectional.Tertiary cardiac care center.All patients who underwent TAVI for severe AS between February 2013 and December 2016 were included. Clinical, imaging, and laboratory information at baseline and at one year follow-up were analyzed.Clinical and echocardiography out.comes at discharge, at 1-month, and at end of follow-up; one-year mortality, complications and clinical response to TAVI procedure.N=80, mean (SD) age 79.5 (10.6) years, with severe AS and high-surgical risk.Fifty-five (69.2%) patients received Core valves, and 25 (30.8%) received Edward valves. Peri-procedure mortality was 3.8% and 1-year post-operative mortality was 13.8%. Ten patients (12.5%) had life-threatening or major bleeding. Nineteen (23.8%) patients had vascular complications, which were mostly minor. Fourteen patients (17.5%) developed acute kidney injury and 86% of these patients recovered. Five patients (6.25%) had pericardial effusion. Two patients (2.5%) developed endocarditis and another 2 patients (2.5%) had cerebrovascular accidents. Five patients (6.25%) received pacemakers. Mean aortic valve gradient significantly reduced from a mean (SD) 47.6 (19) mm Hg to 10.7 (6.0) mm Hg (P less than .001). New York Heart Association functional class was significantly reduced (P less than .001).The TAVI experience at MCC is encouraging and comparable to international outcomes in terms of success, morbidity, and mortality rate.Retrospective, relatively small sample size. Rate of minor bleeding was overestimated.None.

SUBMITTER: Alatawi FO

PROVIDER: S-EPMC6074303 | biostudies-other | 2018 May-Jun

REPOSITORIES: biostudies-other

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Clinical outcomes with transcatheter aortic valve implantation at a single cardiac center in Saudi Arabia.

Alatawi Faisal Owdah FO Abuelatta Reda A RA AlAhmedi Ahmed B AB Alharbi Ibraheem H IH Alghamdi Saleh S SS Sakrana Amal A AA Alamodi Osama A OA Naeim Hesham A HA

Annals of Saudi medicine 20180501 3

<h4>Background</h4>Transcatheter aortic valve implantation (TAVI) has been recognized as a valid alternative to surgery for severe aortic valve stenosis (AS) in high-risk surgical patients.<h4>Objective</h4>Determine first-year clinical outcomes for TAVI at Madinah Cardiac Center (MMC) in Saudi Arabia.<h4>Design</h4>Retrospective, analytical cross-sectional.<h4>Setting</h4>Tertiary cardiac care center.<h4>Patients and methods</h4>All patients who underwent TAVI for severe AS between February 201 ...[more]

PMID: 29848933

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Project description:Despitethe multiple depicted associations of CKD with reduced cardiovascular and overall prognoses, the association of CKD with outcome of patients undergoing transcatheter aortic valve implantation has still not been well described.Data from all hospitalized patients who underwent transcatheter aortic valve implantation procedures between January 1, 2010 and December 31, 2013 in Germany were evaluated regarding influence of CKD, even in the earlier stages, on morbidity, in-hospital outcomes, and costs.A total of 28,716 patients were treated with transcatheter aortic valve implantation. A total of 11,189 (39.0%) suffered from CKD. Patients with CKD were predominantly women; had higher rates of comorbidities, such as coronary artery disease, heart failure at New York Heart Association 3/4, peripheral artery disease, and diabetes; and had a 1.3-fold higher estimated logistic European System for Cardiac Operative Risk Evaluation value. In-hospital mortality was independently associated with CKD stage ?3 (up to odds ratio, 1.71; 95% confidence interval, 1.35 to 2.17; P<0.05), bleeding was independently associated with CKD stage ?4 (up to odds ratio, 1.82; 95% confidence interval, 1.47 to 2.24; P<0.001), and AKI was independently associated with CKD stages 3 (odds ratio, 1.83; 95% confidence interval, 1.62 to 2.06) and 4 (odds ratio, 2.33; 95% confidence interval, 1.92 to 2.83 both P<0.001). The stroke risk, in contrast, was lower for patients with CKD stages 4 (odds ratio, 0.23; 95% confidence interval, 0.16 to 0.33) and 5 (odds ratio, 0.24; 95% confidence interval, 0.15 to 0.39; both P<0.001). Lengths of hospital stay were, on average, 1.2-fold longer, whereas reimbursements were, on average, only 1.03-fold higher in patients who suffered from CKD.This analysis illustrates for the first time on a nationwide basis the association of CKD with adverse outcomes in patients who underwent transcatheter aortic valve implantation. Thus, classification of CKD stages before transcatheter aortic valve implantation is important for appropriate risk stratification.

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Clinical outcomes with transcatheter aortic valve implantation at a single cardiac center in Saudi Arabia.

Publications

Clinical outcomes with transcatheter aortic valve implantation at a single cardiac center in Saudi Arabia.

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