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Incidence and outcomes of emergent cardiac surgery during transfemoral transcatheter aortic valve implantation (TAVI): insights from the European Registry on Emergent Cardiac Surgery during TAVI (EuRECS-TAVI) |
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| Author: | Eggebrecht, Holger1,2; Vaquerizo, Beatriz3; Moris, Cesar4; |
| Organizations: |
1Department of Cardiology, Cardioangiologisches Centrum Bethanien (CCB) at the AGAPLESION Bethanien Hospital, Im Prüfling 21-25, 60389 Frankfurt, Germany 2Department of Cardiology, Herz- Thorax- Zentrum, Klinikum Fulda, Pacelliallee 4, 36043 Fulda, Germany 3Unidad de Cardiología Intervencionista, Departamento de Cardiología, Hospital del Mar, Passeig Marítim 25/29, 08003 Barcelona, Spain
4Área del Corazón, Hospital Universitario Central de Asturias, Roma s/n, 33011 Oviedo, Asturias, Spain
5Cardiology Division “Cava de’Tirreni and Amalfi Coast” Heart Department, University Hospital, Via de Marinis 4, 84013 Cava de’Tirreni, Italy 6Department of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Südring 15, 79189 Bad Krozingen, Germany 7Department of Thoracic and Cardiovascular Surgery, Kepler University Hospital, Krankenhausstr. 9, 4021 Linz, Austria 8Department of Cardiology and Cardiac Surgery, Kerckhoff Heart and Lung Center, Benekestrasse 2-8, 61231 Bad Nauheim, Germany 9Clinic for Cardiology, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr-Universität Bochum, Georgstr. 11, 32545 Bad Oeynhausen, Germany 10Department of Cardiology, Heart Center, University of Cologne, Medizinische Klinik III, Kerpener Str. 3, 50937 Cologne, Germany 11Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria 12Department of Cardiac Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany 13Department of Cardiology, Générale de Santé, Institut Cardiovasculaire Paris-Sud - Hôpital Privé Jacques Cartier, 6 Avenue du Noyer Lambert, 91300 Massy, France 14Department of Cardiovascular Surgery, German Heart Center, Technical University Munich, Lazarettstr. 36, 80636 Munich, Germany 15Medicare Center and Department for Percutaneous Treatment of Structural Heart Disease, Albertinen Heart Center, Wördemannsweg 25-27, 22527 Hamburg, Germany 16Department of Cardiology, Munich University Clinic, Ludwig-Maximilians University Munich and German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany; 17Department of General and Interventional Cardiology, University Heart Center Hamburg, Martinistr. 52, 20246 Hamburg, Germany 18epartment of Cardiology, Contilia Heart and Vascular Centre, Elisabeth-Krankenhaus Essen, Klara-Kopp-Weg 1, 45134 Essen, Germany 19Department of Cardiology, University of Oulu 20Heart Center, University of Turku, Hämeentie 11 P.O. Box 52, 20521 Turku, Finland 21Department of Cardiology, Paracelsus Medical University Nuernberg, General Hospital Nuernberg, Medizinische Klinik 8, Breslauer Str. 201, 90471 Nürnberg, Germany 22ardiology Department. Interventional Cardiology Unit. University Hospital of Angers, 4 rue Larry, 49000 Angers, France 23Department of Cardiology, Toulouse Rangueil Hospital, Toulouse University School of Medicine, 1, Professeur Jean Poulhes Avenue, 31059 Toulouse, France 24Groupe Cardio-Vasculaire Interventionnel Clinique Pasteur, 45 avenue de Lombez BP 27617, 31076 Toulouse, France 25Department of Cardiology, Kuopio University Hospital Heart Center, PL 100, 70029 KYS Kuopio, Finland 26UO Cardiochirurgia Ospedale del Cuore G. Pasquinucci Fondazione Toscana Gabriele Monasterio, Via Aurelia Sud, 54100 Mass, Italy 27Department of Cardiology, Leeds Teaching Hospitals, LS23 6AL Leeds, UK 28Interventional Cardiology Unit, San Raffaele Hospital, Olgettina Street 60, 20132 Milan, Italy 29Department of Cardiology, West German Heart and Vascular Center, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany 30Ist Department of Cardiovascular Surgery, American Heart of Poland Inc., Armii Krajowej 101 Street, 43-316 Bielsko-Biała, Poland 31Valvular Heart Disease Department, National Institute of Cardiology, Alpejske 42, 06-628 Warsaw, Poland 32Cardiology Department, Rabin Medical Center and the “Sackler” Faculty of Medicine, Tel-Aviv University, Jabotinski St. 29, 39100 Petah-Tikva, Israel 33Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, Azienda Ospedaliera-University of Padova, 2 Via Nicoló Giustiniani, 35128 Padova, Italy 34Department of Cardiology, Klinikum Klagenfurt, Sankt Veiter Stra b e 47, Klagenfurt am Wörthersee, Austria 35The Heart Center, Department of Cardiology Rigshospitalet University of Copenhagen, Blegdamsvej 9, 2200 Copenhagen, Denmark 36Department of Cardiology, Galway University Hospitals, Newcastle Road, Galway, Ireland 37Department of Internal Medicine Division of Cardiology Duke University Medical Center and Duke Clinical Research Institute, 2400 Pratt Street Durham NC 27715, Durham, NC, USA |
| Format: | article |
| Version: | accepted version |
| Access: | open |
| Online Access: | PDF Full Text (PDF, 0.1 MB) |
| Persistent link: | http://urn.fi/urn:nbn:fi-fe2019101532796 |
| Language: | English |
| Published: |
Oxford University Press,
2018
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| Publish Date: | 2019-10-15 |
| Description: |
AbstractAims: Life-threatening complications occur during transcatheter aortic valve implantation (TAVI) which can require emergent cardiac surgery (ECS). Risks and outcomes of patients needing ECS during or immediately after TAVI are still unclear. Methods and results: Incidence, risk factors, management, and outcomes of patients requiring ECS during transfemoral (TF)-TAVI were analysed from a contemporary real-world multicentre registry. Between 2013 and 2016, 27 760 patients underwent TF-TAVI in 79 centres. Of these, 212 (0.76%) patients required ECS (age 82.4 ± 6.3 years, 67.5% females, logistic EuroSCORE: 17.1%, STS-score 5.8%). The risk of ECS declined from 2013 (1.07%) to 2014 (0.70%) but remained stable since. Annual TF-TAVI numbers have more than doubled from 2013 to 2016. Leading causes for ECS were left ventricular perforation by the guidewire (28.3%) and annular rupture (21.2%). Immediate procedural mortality (<72 h) of TF-TAVI patients requiring ECS was 34.6%. Overall in-hospital mortality was 46.0%, and highest in case of annular rupture (62%). Independent predictors of in-hospital mortality following ECS were age > 85 years [odds ratio (OR) 1.87, 95% confidence interval (95% CI) (1.02–3.45), P = 0.044], annular rupture [OR 1.96, 95% CI (0.94–4.10), P = 0.060], and immediate ECS [OR 3.12, 95% CI (1.07–9.11), P = 0.037]. One year of survival of the 114 patients surviving the in-hospital period was only 40.4%. Conclusion: Between 2014 and 2016, the need for ECS remained stable around 0.7%. Left ventricular guidewire perforation and annular rupture were the most frequent causes, accounting for almost half of ECS cases. Half of the patients could be salvaged by ECS—nevertheless, 1 year of all-cause mortality was high even in those ECS patients surviving the in-hospital period. see all
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| Series: |
European heart journal |
| ISSN: | 0195-668X |
| ISSN-E: | 1522-9645 |
| ISSN-L: | 0195-668X |
| Volume: | 39 |
| Issue: | 8 |
| Pages: | 676 - 684 |
| DOI: | 10.1093/eurheartj/ehx713 |
| OADOI: | https://oadoi.org/10.1093/eurheartj/ehx713 |
| Type of Publication: |
A1 Journal article – refereed |
| Field of Science: |
3126 Surgery, anesthesiology, intensive care, radiology 3121 General medicine, internal medicine and other clinical medicine |
| Subjects: | |
| Funding: |
The European Registry on Emergent Cardiac Surgery during TAVI (EuRECS-TAVI) is an investigator-initiated multicentre registry without funding. |
| Copyright information: |
Published on behalf of the European Society of Cardiology. All rights reserved. © The Authors 2017. This is a pre-copyedited, author-produced version of an article accepted for publication in European Heart Journal following peer review. The version of record Holger Eggebrecht, Beatriz Vaquerizo, Cesar Moris, Eduardo Bossone, Johannes Lämmer, Martin Czerny, Andreas Zierer, Holger Schröfel, Won-Keun Kim, Thomas Walther, Smita Scholtz, Tanja Rudolph, Christian Hengstenberg, Jörg Kempfert, Marco Spaziano, Thierry Lefevre, Sabine Bleiziffer, Joachim Schofer, Julinda Mehilli, Moritz Seiffert, Christoph Naber, Fausto Biancari, Dennis Eckner, Charles Cornet, Thibault Lhermusier, Raphael Philippart, Antti Siljander, Alfredo Giuseppe Cerillo, Daniel Blackman, Alaide Chieffo, Philipp Kahlert, Katarzyna Czerwinska-Jelonkiewicz, Piotr Szymanski, Uri Landes, Ran Kornowski, Augusto D’Onofrio, Carl Kaulfersch, Lars Søndergaard, Darren Mylotte, Rajendra H Mehta, Ole De Backer, European Registry on Emergent Cardiac Surgery during TAVI (EuRECS-TAVI), Incidence and outcomes of emergent cardiac surgery during transfemoral transcatheter aortic valve implantation (TAVI): insights from the European Registry on Emergent Cardiac Surgery during TAVI (EuRECS-TAVI), European Heart Journal, Volume 39, Issue 8, 21 February 2018, Pages 676–684, https://doi.org/10.1093/eurheartj/ehx713 is available online at: https://doi.org/10.1093/eurheartj/ehx713. |