Left Atrial Diameter, Aortic Mean Gradient, and Hemoglobin for Risk Stratification in Patients Undergoing Transcatheter Aortic Valve Implantation

摘要: Background Transcatheter aortic valve implantation (TAVI) is an alternative treatment of severe symptomatic stenosis (AS) in patients with high operative risk. In spite favorable entire results, long-term mortality high. Hypothesis The present study aims to identify independent preprocedural risk factors improve stratification these highly selected patients. Methods This prospective included 202 consecutive AS and (mean logistic European System for Cardiac Operative Risk Evaluation, 22 ± 17%; mean age, 79 ± 6 years; 107 female). Preprocedural comprehensive examinations were performed (laboratory, electrocardiography, echocardiography, cardiac catheterization). All received transfemoral or transaxillary TAVI a CoreValve prosthesis (Medtronic, Minneapolis, MN). Results During follow-up 535 ± 333 days, 56 (28%) reached the primary end point (all-cause mortality). Independent predictors as follows: hemoglobin  42 mm (HR, 3.09; 95% CI, 1.588–6.019; P = 0.001). Our risk-stratification model based on separated into 4 groups (74%), intermediate (37%), low (18%), very (3%) all-cause mortality. Conclusions In undergoing TAVI, assessment hemoglobin, gradient, left atrial diameter provides prognostic information therefore contributes improved TAVI.