Skip to main content
Journal cover image

2-Year Outcomes After Iliofemoral Self-Expanding Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Stenosis Deemed Extreme Risk for Surgery.

Publication ,  Journal Article
Yakubov, SJ; Adams, DH; Watson, DR; Reardon, MJ; Kleiman, NS; Heimansohn, D; Hermiller, J; Hughes, GC; Harrison, JK; Coselli, J; Diez, J ...
Published in: J Am Coll Cardiol
September 22, 2015

BACKGROUND: We reported favorable 1-year outcomes in patients unsuitable for surgery who underwent self-expanding transcatheter aortic valve replacement (TAVR) compared with an objective performance goal. Longer-term outcomes in these patients are not known. OBJECTIVES: This study sought to evaluate the 2-year safety and efficacy in patients with severe aortic stenosis (AS) at extreme risk of surgery treated with self-expanding TAVR. METHODS: We performed a prospective, multicenter, controlled, nonrandomized investigation of self-expanding TAVR in patients with severe AS and prohibitive surgical risk. We report the 2-year clinical outcomes in these patients. RESULTS: A total of 489 extreme-risk patients were treated transfemorally with a self-expanding aortic bioprosthesis at 41 centers. The rate of all-cause mortality or major stroke was 38.0% at 2 years (all-cause mortality, 36.5%; major stroke, 5.1%). The rates of all-cause mortality, cardiovascular mortality, and major stroke were 36.6%, 26.2%, and 5.1%, respectively, at 2 years. Between 1 and 2 years, the incremental all-cause mortality, cardiovascular mortality, and major stroke rates were 12.3%, 7.9%, and 0.8%, respectively. Multivariable predictors of all-cause mortality at 2 years included the presence of coronary artery disease and admission from an assisted living center. A Society of Thoracic Surgeons score >15% was also predictive of 2-year all-cause mortality. At 2 years, 94% of patients had New York Heart Association functional class I or II symptoms. The frequency of moderate or severe paravalvular regurgitation (4.3% at 1 year; 4.4% at 2 years) was unchanged between the first and second year. CONCLUSIONS: Patients with severe AS at extreme surgical risk treated with self-expanding TAVR continued to show good clinical outcomes and hemodynamic valve performance at 2 years. The presence of comorbid conditions rather than valve performance affected 2-year outcomes in these patients. (Safety and Efficacy Study of the Medtronic CoreValve System in the Treatment of Symptomatic Severe Aortic Stenosis in High Risk and Very High Risk Subjects Who Need Aortic Valve Replacement; NCT01240902).

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

September 22, 2015

Volume

66

Issue

12

Start / End Page

1327 / 1334

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Transcatheter Aortic Valve Replacement
  • Prospective Studies
  • Male
  • Humans
  • Female
  • Echocardiography
  • Cardiovascular System & Hematology
  • Aortic Valve Stenosis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Yakubov, S. J., Adams, D. H., Watson, D. R., Reardon, M. J., Kleiman, N. S., Heimansohn, D., … CoreValve United States Clinical Investigators. (2015). 2-Year Outcomes After Iliofemoral Self-Expanding Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Stenosis Deemed Extreme Risk for Surgery. J Am Coll Cardiol, 66(12), 1327–1334. https://doi.org/10.1016/j.jacc.2015.07.042
Yakubov, Steven J., David H. Adams, Daniel R. Watson, Michael J. Reardon, Neal S. Kleiman, David Heimansohn, James Hermiller, et al. “2-Year Outcomes After Iliofemoral Self-Expanding Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Stenosis Deemed Extreme Risk for Surgery.J Am Coll Cardiol 66, no. 12 (September 22, 2015): 1327–34. https://doi.org/10.1016/j.jacc.2015.07.042.
Yakubov SJ, Adams DH, Watson DR, Reardon MJ, Kleiman NS, Heimansohn D, et al. 2-Year Outcomes After Iliofemoral Self-Expanding Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Stenosis Deemed Extreme Risk for Surgery. J Am Coll Cardiol. 2015 Sep 22;66(12):1327–34.
Yakubov, Steven J., et al. “2-Year Outcomes After Iliofemoral Self-Expanding Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Stenosis Deemed Extreme Risk for Surgery.J Am Coll Cardiol, vol. 66, no. 12, Sept. 2015, pp. 1327–34. Pubmed, doi:10.1016/j.jacc.2015.07.042.
Yakubov SJ, Adams DH, Watson DR, Reardon MJ, Kleiman NS, Heimansohn D, Hermiller J, Hughes GC, Harrison JK, Coselli J, Diez J, Schreiber T, Gleason TG, Conte J, Deeb GM, Huang J, Oh J, Byrne T, Caskey M, Popma JJ, CoreValve United States Clinical Investigators. 2-Year Outcomes After Iliofemoral Self-Expanding Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Stenosis Deemed Extreme Risk for Surgery. J Am Coll Cardiol. 2015 Sep 22;66(12):1327–1334.
Journal cover image

Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

September 22, 2015

Volume

66

Issue

12

Start / End Page

1327 / 1334

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Transcatheter Aortic Valve Replacement
  • Prospective Studies
  • Male
  • Humans
  • Female
  • Echocardiography
  • Cardiovascular System & Hematology
  • Aortic Valve Stenosis